LIDOCAINE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
ii
ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Lidocaine: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00662-6 1. Lidocaine-Popular works. I. Title.
iii
Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail:
[email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.
iv
Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on lidocaine. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
v
About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
vi
About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
vii
Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON LIDOCAINE ................................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Lidocaine ....................................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 39 The National Library of Medicine: PubMed ................................................................................ 40 CHAPTER 2. NUTRITION AND LIDOCAINE ...................................................................................... 83 Overview...................................................................................................................................... 83 Finding Nutrition Studies on Lidocaine ...................................................................................... 83 Federal Resources on Nutrition ................................................................................................... 85 Additional Web Resources ........................................................................................................... 86 CHAPTER 3. ALTERNATIVE MEDICINE AND LIDOCAINE................................................................ 87 Overview...................................................................................................................................... 87 National Center for Complementary and Alternative Medicine.................................................. 87 Additional Web Resources ........................................................................................................... 94 General References ....................................................................................................................... 95 CHAPTER 4. DISSERTATIONS ON LIDOCAINE.................................................................................. 97 Overview...................................................................................................................................... 97 Dissertations on Lidocaine........................................................................................................... 97 Keeping Current .......................................................................................................................... 98 CHAPTER 5. PATENTS ON LIDOCAINE ............................................................................................ 99 Overview...................................................................................................................................... 99 Patents on Lidocaine .................................................................................................................... 99 Patent Applications on Lidocaine .............................................................................................. 121 Keeping Current ........................................................................................................................ 130 CHAPTER 6. BOOKS ON LIDOCAINE .............................................................................................. 131 Overview.................................................................................................................................... 131 Book Summaries: Online Booksellers......................................................................................... 131 Chapters on Lidocaine ................................................................................................................ 131 CHAPTER 7. MULTIMEDIA ON LIDOCAINE ................................................................................... 135 Overview.................................................................................................................................... 135 Video Recordings ....................................................................................................................... 135 CHAPTER 8. PERIODICALS AND NEWS ON LIDOCAINE ................................................................ 137 Overview.................................................................................................................................... 137 News Services and Press Releases.............................................................................................. 137 Academic Periodicals covering Lidocaine .................................................................................. 140 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................. 141 Overview.................................................................................................................................... 141 U.S. Pharmacopeia..................................................................................................................... 141 Commercial Databases ............................................................................................................... 142 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 147 Overview.................................................................................................................................... 147 NIH Guidelines.......................................................................................................................... 147 NIH Databases........................................................................................................................... 149 Other Commercial Databases..................................................................................................... 151 APPENDIX B. PATIENT RESOURCES ............................................................................................... 153 Overview.................................................................................................................................... 153 Patient Guideline Sources.......................................................................................................... 153 Finding Associations.................................................................................................................. 155
viii Contents
APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 157 Overview.................................................................................................................................... 157 Preparation................................................................................................................................. 157 Finding a Local Medical Library................................................................................................ 157 Medical Libraries in the U.S. and Canada ................................................................................. 157 ONLINE GLOSSARIES................................................................................................................ 163 Online Dictionary Directories ................................................................................................... 163 LIDOCAINE DICTIONARY........................................................................................................ 165 INDEX .............................................................................................................................................. 253
1
FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with lidocaine is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about lidocaine, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to lidocaine, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on lidocaine. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to lidocaine, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on lidocaine. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
3
CHAPTER 1. STUDIES ON LIDOCAINE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on lidocaine.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and lidocaine, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “lidocaine” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Unusual Symptom of Lidocaine Allergy Source: New York State Dental Journal. NYSDJ. 68(10): 24-25. December 2002. Contact: Available from Dental Society of the State of New York. 7 Elk Street, Albany, NY 12207. (518) 465-0044. Summary: The incidence of lidocaine allergy is rare, with only 1 percent of all reported incidents representing true antigen antibody allergic reactions. This article presents a confirmed case of antigen antibody reaction to lidocaine. These immunoglobulin Emediated responses can include anaphylaxis, urticaria, hay fever, and asthma. This case is further distinguished by the unusual presence of blurred vision in the patient. The author reviews the other reported adverse reactions to lidocaine and their causes. The author stresses that reported symptoms alone do not affirm a case of lidocaine allergy.
4
Lidocaine
It is immunological testing and the onset time of symptoms that confirm the true antigen antibody reaction. 7 references. •
Identifying True Lidocaine Allergy Source: JADA. Journal of the American Dental Association. 125(9): 1362-1366. October 1994. Summary: This article discusses the importance of diagnosing and verifying allergies to local anesthetics, notably lidocaine. The authors present a case report of a suspected allergic reaction to a local anesthetic administered during dental treatment. They note that sometimes an apparent allergic reaction can be brought on by anxiety. Commonly used and available allergy tests also are reviewed. Specific topics covered include allergic reaction mechanisms, anaphylaxis, urticaria, hay fever, and asthma. 2 figures. 8 references. (AA-M).
Federally Funded Research on Lidocaine The U.S. Government supports a variety of research studies relating to lidocaine. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to lidocaine. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore lidocaine. The following is typical of the type of information found when searching the CRISP database for lidocaine: •
Project Title: AIRWAY SENSORY NERVES AND DYSPNEA IN HUMAN SUBJECTS Principal Investigator & Institution: Burki, Nausherwan K.; Professor of Medicine; Internal Medicine; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-DEC-2004 Summary: (provided by applicant): Dyspnea, an unpleasant sensation of difficulty in breathing, is a common symptom in patients with cardiopulmonary diseases, but the underlying mechanisms are unclear. Amongst the various neural pathways, unmyelinated vagal C fibers arising from the lungs and airways have been implicated. The long-term objectives are to increase understanding of the mechanisms of dyspnea and specifically the role of pulmonary C fibers. Adenosine is a commonly used therapeutic intravenous drug for treatment of supraventricular tachycardia; it has been frequently reported to cause dyspnea. Recent studies from our laboratory reported the first evidence showing that adenosine stimulates pulmonary C fiber receptors in
2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
Studies
5
anesthetized rats. Preliminary human studies from our laboratory indicate that intravenous adenosine causes dyspnea and increase ventilation, and neither affect is associated with bronchoconstriction. Adenosine is known to increase ventilation by stimulating the carotid body chemoreceptors; such reflex stimulation would increase central motor command and could lead to the development of dyspnea. Our hypothesis is that adenosine causes dyspnea by direct activation of pulmonary C fiber, and it is not an indirect effect related to the increase in ventilation. The specific aims of the proposed study are: 1) to determine the latency and magnitude of dyspneic response, change in airway resistance, and ventilatory response to intravenous injection of adenosine in normal subjects and stable asthmatics; 2) to evaluate the effects of pretreatment with theophylline, and adenosine receptor antagonist, on the intensity of dyspnea and the ventilatory effects of intravenous adenosine; 3) to examine whether directly blocking pulmonary C fibers with inhaled lidocaine abolishes the sensation of dyspnea induced by adenosine in these subjects/patients; 4) to investigate if pretreatment with 100 percent O2, by reducing carotid chemoreceptor sensitivity, alters the dyspnogenic and ventilatory effects of intravenous adenosine. These studies should bring a better understanding of the underlying mechanism of adenosine-induced dyspnea and the role of bronchopulmonary C fibers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AUTONOMIC CONTROL OF BLOOD FLOW TO EXERCISING MUSCLE Principal Investigator & Institution: Clifford, Philip S.; Professor; Anesthesiology; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532260509 Timing: Fiscal Year 2002; Project Start 15-JUL-1999; Project End 30-JUN-2003 Summary: (Adapted from the applicant's abstract): Despite decades of investigation and innumerable studies, an understanding of the role of the autonomic nervous system in regulating skeletal muscle blood flow during exercise remains elusive. It is well known that muscarinic receptors can mediate smooth muscle relaxation in the arterial vasculature of skeletal muscle, but their participation in the skeletal muscle hyperemia at the onset of exercise is uncertain. Relaxation of vascular smooth muscle can also occur via activation of ATP sensitive potassium channels. Preliminary data described in this application implicate these channels as the transduction mechanism for exerciseinduced skeletal muscle vasodilation. The evidence that the sympathetic nervous system constrains blood flow to dynamically exercising muscle is contradictory, but a recent study from the applicant's laboratory established that there is alpha 1 adrenergic restraint of blood flow to active skeletal muscle. Pilot data included in this application also demonstrate the existence of tonic alpha 2 receptor mediated vasoconstriction in active skeletal muscles during dynamic exercise. The working hypothesis underlying this proposal is that the autonomic nervous system does not affect the rate or magnitude of vasodilation in skeletal muscle at the onset of exercise, but actively constrains blood flow to active skeletal muscle during steady state exercise. To elucidate the role of the autonomic nervous system in the control of skeletal muscle blood flow during exercise, the following specific aims are proposed: Aim 1: To determine if there is an autonomic component to the rapid vasodilation which occurs in skeletal muscle at the onset of dynamic exercise. Aim 2: To examine the mechanism of sympathetic vasoconstriction in dynamically exercising skeletal muscle. The ability to deliver agonists and antagonists to a discrete vascular bed in conscious, exercising animals is a major strength of the protocols described. The proposed studies will provide valuable new information regarding the basic physiological mechanisms by which blood flow is regulated to
6
Lidocaine
skeletal muscle at rest and during exercise. This issue is of fundamental importance to be addressed by straightforward experiments. In addition, an understanding of how ischemia affects alpha 1 and alpha 2 mediated vasoconstriction may have important implications for individuals with peripheral vascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BEHAVIORAL AND NEURAL PLASTICITY IN FOOD-STORING BIRDS Principal Investigator & Institution: Shiflett, Michael W.; Psychology; Cornell University Ithaca Office of Sponsored Programs Ithaca, Ny 14853 Timing: Fiscal Year 2002; Project Start 16-MAY-2002; Project End 15-MAY-2003 Summary: adapted from applicant?s abstract) This research project examines learning and plasticity in the hippocampus of food-storing birds. The first three experiments address the role of the hippocampus in spatial memory processing, through the use of reversible inactivation or injection of receptor antagonists. The fourth experiment examines factors that may induce seasonal neurogenesis by manipulating experience and hormone levels. This research will contribute to our understanding of the neural basis of learned behaviors in the following ways; first, by studying a natural behavior, we can increase the generality and validity of our current theories on the neural basis of learning and memory. Second, by studying a system with remarkable adult neural plasticity, we may better understand the link between plasticity in the nervous sytem and changes in cognitive function. This in turn may be relevant to therapeutic strategies involving brain repair, by revealing the mechanisms through which adult generated neurons become functionally integrated into the nervous system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: BRAIN AND SPINAL CORD CONTRIBUTIONS TO ANESTHETIC ACTION Principal Investigator & Institution: Antognini, Joseph F.; Anesthesiology & Pain Medicine; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 956165200 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-MAR-2006 Summary: (provided by applicant) Our research efforts have been directed towards elucidation of anatomic sites of anesthetic action. Our earlier studies indicated that anesthetics such as isoflurane depress the movement response that occurs following noxious stimulation via an action in the spinal cord. In the past grant cycle we determined that isoflurane and propofol action in the spinal cord depressed the ascending transmission of nociceptive impulses to the brain. This resulted in ablation of the noxious-evoked activation of the electroencephalogram (EEG) and single-units in the thalamus and midbrain reticular formation (MRF). Because the MRF and thalamus are critical to consciousness and memory, it is likely that disruption of nociceptive input to these sites decreases the likelihood of consciousness and memory formation during anesthesia. In this proposal we aim to 1) determine whether isoflurane and propofol action at the spinal level affects the "arousal" state of the brain, as measured by MRF, pedunculopontine tegmental (PPT) and medial thalamic stimulation-induced effects on the EEG; 2) determine the neurotransmitter systems that modulate the ascending transmission of nociceptive impulses to the brain, and how isoflurane and propofol affect these systems. We hypothesize that 1) isoflurane and propofol will increase the threshold stimulation current in the MRF, PPT and medial thalamus required to cause
Studies
7
EEG activation; 2) glutamatergic agonists, glycinergic antagonists and GABAergic antagonists applied to the spinal cord will enhance, while glutamatergic antagonists and GABAergic agonists will depress, the ascending transmission of nociceptive impulses to the brain, and thereby cause EEG activation; 3) isoflurane and propofol will indirectly depress evoked glutamate, aspartate and acetylcholine, but enhance GABA concentrations in the cerebral cortex and medial thalamus via an action in the spinal cord. The results of these projects will further our understanding of the in vivo sites where isoflurane and propofol exert their effects. This information will aid the development of newer and safer anesthetics, as well as lead to clinically useful means of modulating the neurotransmitter systems that are themselves modulated by anesthetics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANALGESIA
BRAIN
IMAGING
AND
PAIN:
ANALYSIS
OF
PLACEBO
Principal Investigator & Institution: Robinson, Michael E.; Professor; Clinical & Health Psychology; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2003; Project Start 15-MAR-2003; Project End 31-DEC-2006 Summary: (provided by applicant): This project is designed to investigate the neural mechanisms of placebo analgesia. An innovative placebo protocol that assesses the placebo response to both visceral and cutaneous pain stimulation will be employed. Functional Magnetic Resonance Imaging (fMRI) will enable the characterization of brain mechanisms involved in placebo analgesia in a clinical population which experiences visceral pain as part of their clinical syndrome. This project will capitalize on previous work with Irritable Bowel Syndrome (IBS) patients where differential brain activation was demonstrated to visceral and cutaneous pain stimuli. In this same population a powerful and reliable placebo response to specific expectancy response sets has been demonstrated. The proposed project will combine these protocols to obtain brain images of IBS subject during natural history, placebo, and active agent (rectal lidocaine) conditions. It is anticipated that results will show that the placebo response will selectively activate specific brain regions. Neural activity (as measured by rCBF) will be greater in natural history conditions as compared to placebo conditions in the following brain regions: - lateral and/or medial thalamus, somatosensory areas 1 and 2, insular cortex, anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and prefrontal cortex. Furthermore, placebo mechanisms that operate primarily through attenuation of nociceptive signals at lower nervous system levels (spinal cord) will be evidenced by decreased thalamic, somatosensory, ACC, and PCC activation. Previous research indicates that expectancy and desire for pain relief will significantly predict the pain reduction from placebo. It is anticipated that these measures will also be associated with the above described brain activation patterns. By comparing the placebo conditions to the rectal lidocaine condition, brain and central nervous system related mechanisms versus peripheral (receptor site) related mechanisms will be differentiated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CARDIAC NA+ CHANNEL GATING AND LOCAL ANESTHETIC BLOCK Principal Investigator & Institution: Wright, Sterling N.; Biological Sciences; Murray State University Murray, Ky 420713318 Timing: Fiscal Year 2004; Project Start 01-APR-2000; Project End 31-MAR-2007
8
Lidocaine
Summary: (provided by applicant): The long-term objectives of this project are (1) to identify the specific regions within voltage-gated sodium channels that govern channel activation, and (2) to develop a unified model of local anesthetic interaction with sodium channels that includes channel activation and inactivation parameters. Given the importance of channel gating to receptor modulation and local anesthetic block, a better understanding of the channel gating mechanism will be a critical step toward explaining why clinically important local anesthetics, such as bupivacaine and lidocaine, affect cardiac physiology at circulating concentrations that have little effect on skeletal muscle physiology. Numerous studies have used site-directed mutagenesis techniques to alter the kinetic phenotypes of sodium channel isoforms cloned from cardiac and skeletal muscle, yet no study has identified the channel regions responsible for the more hyperpolarized activation and inactivation ranges of cardiac sodium channels as compared with skeletal muscle sodium channels. To date, careful screening of the amino acid sequences of cardiac and skeletal muscle sodium channels and "residue swapping" between the two isoforms at suspected regions of importance to channel gating have had limited success. This proposal uses an alternative approach to address questions of isoform-specific gating in sodium channels. Neurotoxins that bind to sites 2, 3, and 4 on voltage gated sodium channels alter channel kinetics and other channel properties such as ionic selectivity. Whole-cell sodium currents through human heart (hH1) and rat skeletal (mu1) muscle sodium channels will be compared before and after modification by neurotoxins. The goal is to identify isoform-specific changes in channel kinetics, ionic selectivity, and local anesthetic interactions at toxin-modified channels. Because several residues critical for neurotoxin binding have already been localized, isoform-specific alterations in channel behavior after toxin modification can be used to target channel regions that are potentially important to channel gating. Analyses of the differences between toxin-modified hH1 and u1 channels will be used to design mutant channels and channel chimeras to further narrow the search for channel regions that are important in channel gating. Once the gating mechanism of the channels has been deduced, current models of local anesthetic block can be modified to explain the elevated sensitivity of cardiac tissue to antiarrhythmic and cardiotoxic local anesthetics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CELL ASSEMBLIES, PATTERN COMPLETION AND THE AGING BRAIN Principal Investigator & Institution: Barnes, Carol A.; Professor; Psychology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 15-APR-1994; Project End 30-JUN-2004 Summary: (Adapted from applicant's abstract): The research proposal is a resubmission of a grant that was reviewed in June, 1998. The proposed research will investigate hippocampal electrophysiology in young and old rats in three experiments examining hippocampal sensitivity to disruption, the relationship between place field stability and spatial memory performance, and the relationship between these and long-term potentiation mechanisms.The first experiment is designed to test whether or not the old hippocampus is near threshold for retrieval failure due to loss of synapses and synaptic plasticity. The PI will record groups of cells in the right hippocampus before and after the rats' left hippocampus is injected with lidocaine via indwelling cannula. The rats will seek electrical brain stimulation reward in two similar chambers during the recording sessions. The hypothesis predicts that older rats will be more sensitive to the unilateral hippocampal inactivation, and that both memory performance and hippocampal representations will be less consistent in older rats than younger rats.The
Studies
9
second experiment is designed to determine if instabilities in hippocampal firing fields correlate with memory performance errors. The PI will record groups of hippocampal cells in young and old rats trained to operate an RCV--a rat controlled vehicle. The RCV apparatus allows the independent experimental control of the rat's movement, and its vestibular and visual experience. Trials will include both experimenter and ratcontrolled movements with respect to locations and rewarded goal locations. The task for the rat will be to press a lever to control the movement of a mechanical arm to approach a goal. Old animals are expected to have poorer goal targeting with respect to the distal cues in the apparatus compared to young rats. Specifically, the changes in the location of a (group of) cell's place field(s) with respect to visual cues is expected to predict the rat's errors in finding goals.The third experiment will test the extent two which placefield properties involve NMDA receptor dependent plasticity and AMPA receptor associated ion currents. Young rats will be given NMDA receptor antagonists and several experience-dependent changes in place fields will be assessed. Old rats will be given drugs that increase AMPA currents. Hippocampal cell activity in both groups of rats will be assessed in a circular track and during sleep. NMDA receptor antagonists are expected to prevent experience-dependent place field changes in the young rats, and AMPA current enhancers are expected to ameliorate place field properties in the old rats. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CNS LESIONS EFFECTS ON DRUG ACTION Principal Investigator & Institution: Harvey, John A.; Professor; Pharmacology and Physiology; Drexel University College of Medicine 245 N 15Th St Philadelphia, Pa 19102 Timing: Fiscal Year 2002; Project Start 01-SEP-1988; Project End 31-MAY-2004 Summary: (Applicant's Abstract) Our previous research, employing classical conditioning of the rabbit's nictitating membrane response has demonstrated that both associative learning and motor performance are critically dependent on the normal activity of the inferior olivary nucleus. Learning during classical conditioning involves a precise timing mechanism as indicated by its exquisite sensitivity to the temporal parameters of stimulus interval. Our work and that of others suggest that the synchronized oscillatory activity of olivary neurons may provide this timing mechanism. Moreover, serotonin (5-HT) has been demonstrated to regulate the rhythmic activity of the inferior olivary nucleus and also to determine the rate of learning and its motor expression. Both of these actions are mediated by the 5-HT2A receptor. Thus, we have hypothesize that 5-HT agonists and antagonists can increase or decrease the rate of learning and optimum level of motor function by acting at 5-HT2A receptors located on olivary neurons so as to enhance the ability of the olive to coordinate a neural network that determines the efficiency of learning and its motor expression. Experiments will be carried out to produce general or specific 5-HT denervations in order to assess the role of presynaptic 5-HT release on the acquisition of learning and motor performance. Systemic and intracerebral injections of 5-HT2A agonists and antagonists will allow us to identify the critical sites at which normal function can be restored. Other experiments will examine the 5-Ht mechanisms through which tremorogenic agents that act directly on the inferior olive impair learning and performance. Finally, we will examine whether the ability of some 5-HT2A antagonists to retard learning and motor function is due to their actions as inverse agonists. These experiments will provide clues concerning the role of the olivocerebellar system in learning and motor performance and possibly in the treatment of dysfunctions in learning and motor function. For example, 5-HT has been implicated in essential tremor
10
Lidocaine
and 5-HT2A receptor blockade has been demonstrated to be sufficient for antipsychotic action. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CNS STRESS PATHWAYS AND THE DEVELOPMENT OF ACUTE HAAF Principal Investigator & Institution: Lattemann, Dianne F.; Research Professor; Psychology; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-JUL-2004 Summary: (provided by applicant): A major complication for insulin-requiring diabetic individuals is the development of Hypoglycemia Associated Autonomic Failure, or HAAF. In the acute form of the syndrome the experience of two or more bouts of hypoglycemia within a 24-hour period results in a blunting of the neuroendocnne counterregulatory response which would normally correct plasma glucose levels. This phenomenon can be modeled in non-diabetic humans and experimental animals, and appears to represent a form of 'stress adaptation'. With other stressors, repeated exposure to the same stressor results in a blunting of the neuroendocrine stress response to that stress. We have developed a rat model of HAAF and have found that, concomitant with the blunted neuroendocnne response, patterns of brain activation (reflected in expression of c-fos) are altered when rats are exposed to three (vs. one) bouts of hypoglycemia in a 24-hr period. Specifically c-fos was decreased in the paraventricular (PVN) and dorsomedial (DMH) hypothalamic areas, with no change in activation of the posterior paraventricular nucleus of the thalamus (THPVP), a region which has net inhibitory input to the PVN. We concluded that a combination of decreased stimulatory input (DMH) and unchanged inhibitory input (THPVP) to the PVN may play a significant role in the decreased neural activation of the PVN and thus decreased downstream neuroendocrine activation. In this series of studies we propose to test the roles of these two brain areas, which are important in the mediation of neuroendocnne responses to other types of stressors, in the neuroendocrine response to hypoglycemic stress and in the development of HAAF. We will reversibly inactivate the THPVP and the DMH with lidocaine or the inhibitory GABA analog muscimol and measure neuroendocnne responses to hypoglycemia, with hypothesized outcomes of reversal of HAAF or simulation of HAAF, respectively. Additionally, we will test the hypothesis that a net increase of inhibitory input at the PVN (reflected by GABAergic transmission) causes the expression of HAAF, by blocking GABAergic activity in the PVN in rats that are experiencing a third bout of hypoglycemia. Together these studies will provide new insight into the role of two stress-regulatory brain regions in the normal counterrregulatory response to hypoglycemia, and in the expression of HAAF; and they will further validate the role of the PVN in mediating counterregulation to hypoglycemia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: COGNITIVE ASPECTS OF ADDICTION-RELATED BEHAVIOR Principal Investigator & Institution: Kantak, Kathleen M.; Professor; Psychology; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 20-APR-1998; Project End 28-FEB-2004 Summary: (Applicant's Abstract) Recent advances in imaging technology have begun to indicate that several brain sites, previously shown to be associated with different memory systems, are activated during craving induced by cocaine-associated cues in
Studies
11
human subjects. Studies suggest a link between limbic and cortical structures in mediating drug craving and underscore the possible importance of cognitive processes for this and other aspects of drug addiction. The proposed plan is to use a neural systems approach to examine the relationships between different memory systems and addiction-related behavior studied with a second-order schedule of intravenous cocaine and morphine delivery in rats. A second-order schedule of drug delivery measures behaviors thought to be related to drug craving and to drug use. Two complementary projects are proposed. The first project will identify how information from different memory systems regulates addiction-related behavior. Addiction-related behavior will be measured during cocaine maintenance and reinstatement (relapse) that follow a period of drug withdrawal. Bilateral infusions of lidocaine and TTX will be used to temporarily and reversibly block neuronal activity, and the roles of specific sites within the four major memory systems (basolateral amygdala, hippocampus, dorsal striatum and prefrontal cortex) in regulating drug-seeking and drug-consummatory behavior will be compared. The completion of this project may identify the functional mechanisms and anatomical pathways by which cognition and drug craving, use and relapse are connected. In the second project, rats will be maintained on a second-order schedule of cocaine or morphine delivery and their performance on a battery of cognitive tasks will be compared to the performance of drug-yoked and saline-yoked rats. Tasks will include those that target hippocampal, basolateral amygdala, dorsal striatal and prefrontal cortex memory functions. These procedures will isolate the specific consequences of persistent drug self-administration from those of a general pharmacological effect of the drug on cognitive performance. The generality of the effects of addiction related behavior on cognitive performance can be determined by comparing different drugs of abuse which differ in mechanism of action. This project may identify the unique cognitive challenges that face a drug-addicted individual Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CYP3A FUNCTION IN AGING AFRICANAMERICANS Principal Investigator & Institution: Greenblatt, David J.; Professor and Chair; Pharmacol & Exper Therapeutics; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2007 Summary: (provided by applicant): The Cytochrome P450-3A (CYP3A) drugmetabolizing enzymes are responsible for the biotransformation and clearance of a large number of drugs used in contemporary clinical therapeutics. Individual variation in the expression and activity of CYP3A, both in the liver and gastrointestinal (GI) tract mucosa, appears to underlie much of the large individual variability in pharmacokinetics and response to therapeutically-administered medications that are CYP3A substrates. Many clinical studies demonstrate that age, gender, and ethnicity (race) may account for components of this variation in predictable ways. For example, some data suggest that clearance of certain CYP3A drugs: a Becomes reduced in old age; b Is higher in women than in men; c Is greater in African-Americans than in Caucasians. However the available data are not by any means consistent. Furthermore, variants in the CYP3A4, CYP3A5, and Pregnane-X receptor genes may modulate age-, gender-, or ethnicity-related variations in CYP3A function in ways that are not understood. This study will prospectively evaluate cohorts of young (18-45 years), "young" elderly (60-69 years) and "old" elderly (>70 years) volunteers, consisting of African-American and Caucasian men and women. The study paradigm will assess: a. Hepatic blood flow (HBF), based on clearance of low-dose intravenous lidocaine; b Pharmacokinetics and pharrnacodynamics of intravenous and oral midazolam, a "pure" CYP3A substrate; c
12
Lidocaine
The prevalence of variants in the CYP3A4, CYP3A5, and pregnane-X receptor genes, using molecular genetic techniques; d. Plasma concentrations of biologically active testosterone. From a. and b., it is possible to estimate midazolam clearance by both routes, net oral bioavailability, and bioavailability attributable to hepatic and gastrointestinal presystemic extraction. With appropriate statistical techniques, the contributions of age, gender, and ethnicity to overall variance can be determined, as well as modulation of the relationships by genetic CYP3A variants and by biologically active testosterone. This study should provide important mechanistic information on the role of age, gender, and ethnicity as sources of variability in CYP3A-mediated drug metabolism and response. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEFINING THE ACCESS PATH FOR LOCAL ANESTHETIC DRUGS Principal Investigator & Institution: Lee, Peter J.; Neurobiology/Pharmacology/Phys; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2002; Project Start 01-FEB-2002 Summary: The voltage-gated Na+ channel plays an important role in many serious arrhythmias and is the target of many antiarrhythmic drugs. While these drugs may control arrhythmia, they are often proarrhythmic and may contribute to sudden cardiac death. Their clinical efficacy and proarrhythmic potential can be attributed to their kinetic interaction with the Na+ channel. Major factors controlling their pharmacokinetics relate to the differential affinities toward gating states of the Na+ channel and differential uses of access paths to their binding site, guarded by activation and inactivation gates. These factors also underlie the differences in clinical behavior of open-channel blocking drugs such as flecainide and quinidine and inactivated-channel blocking drugs such as lidocaine and mexilitine. The current proposal addresses issues of drug- access paths in three parts; 1) to determine whether lidocaine uses an external hydrophilic path to affect its pharmacokinetics, 2) to develop methods to define hydrophilic and hydrophobic access paths important in the pharmacokinetics, and 3) to investigate possible differences in the access paths used by open-channel and inactivated-channel blocking drugs. The study may also result in further information on structural features of the Na+ channel important in drug-channel interaction and offer better insights for safer use and new design of antiarrhythmic drugs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: DEVELOPMENT OF A NOVEL BIOARTIFICIAL LIVER Principal Investigator & Institution: Rozga, Jacek; Arbios Technologies, Inc. 2331 Buckingham Ln Los Angeles, Ca 90077 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 30-NOV-2003 Summary: ARBIOS developed a novel hybrid bioartificial live r(HyBAL) to treat patients with liver failure of various etiologies. In the absence of any other alternative, such patients must receive a liver transplant or endure prolonged hospitalization. In treating acute liver failure it is critical to provide whole liver functions. It is believed that liver support at this level of complexity requires utilization of viable isolated liver cells. Our own argument, which dates back to the development of our first-generate bioartificial liver, is that a truly effective system should be a hybrid one, i.e., it should combine liver cell therapy and detoxification using sorbents (e.g., activated charcoal, exchange resin). The HYBAL is the first liver assist system in which these two functions are integrated in a single molecule. Depending on the cause of liver disease, severity of
Studies
13
illness and deficiency of specific liver functions, these modes of therapy can be provided individually, simultaneously or sequentially. In addition, the HYBAL's basic commercially available kidney dialysis platform represents a major improvement in efficiency with a concomitant reduction in cost and complexity compared to other existing systems. The goal of this proposal is to validate the HyBAL concept. The prototype HyBAL devices will utilize matrix-anchored rat or pig hepatocytes and sorbents (charcoal and exchange resin particles). They will e perfused for 8 hours with plasma removed with pigs with surgically-induced fulminant hepatic failure(FHF). Changes in plasma levels of ammonia, urea, bilirubin and other liver-specific parameters will be monitored. In addition, the HyBAL will be challenged with exogenous ammonium chloride, galactose and lidocaine. In vivo, he ability of HyBAL to support pigs with FHF will be examined. In both experimental settings, HyBAL devices from which either cell therapy or sorbents have been omitted, will be tested to determine the respective role of cell and sorption therapy in the overall HyBAL performance. PROPOSED COMMERCIAL APPLICATIONS: The National Center for Health Statistics (NCHS) reported that in 1999, over 250,000 patients underwent 340,000 hospitalizations due to acute liver failure; 43,000 patients died (7th leading cause of death). Based on these data, NCHS estimates that more than 200,000 liver support treatments are needed annually in the U.S. lone to keep liver failure patients alive until an organ becomes available for transplantation or the native liver recovers from injury ($1.5-billion market). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEVELOPMENT ANESTHETICS
OF
SENSORY/PAIN-SELECTIVE
LOCAL
Principal Investigator & Institution: Gerner, Peter; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant) The candidate is an Instructor in Anesthesiology at Brigham and Women's Hospital, Boston, MA. He will use the next 5 years to acquire basic molecular biology and electrophysiology skills to achieve his long-term goal of developing clinically useful pharmacological agents for the safe and specific treatment of pain. Local anesthetics (LAs) are used routinely for surgical anesthesia and for management of acute and chronic pain from all causes. In addition to blocking voltagegated Na+ channels in sensory nerves fibers, LAs also block Na+ channels in motor and sympathetic fibers, as well as in brain and heart. Therefore, complete pain relief often cannot be accomplished, or serious adverse effects occur, e.g., cardiac arrest, seizures, low blood pressure, and motor blockade causing immobility. The specific aims of this proposal are (1) To identify novel drugs with LA properties in vivo and in vitro. (2) To examine these drugs for pain-selective properties. (3) To define their affinities to both the activated and inactivated states of different Na+ channel isoforms and (4) Using site directed mutagenesis, map the LA receptor in sensory neuron-specific Na+ channels to aid in future drug design. Whole-cell voltage-clamp recordings of newly developed quaternary ammonium (QA) derivatives of lidocaine (tonicaine) and amitriptyline (e.g., N-methyl amitriptyline) defined a high level of additional block (use-dependent block) when neuronal cells were stimulated at a high frequency. These QA drugs will be used to study the hypothesis that they selectively treat conditions caused by high-frequency discharge, e.g., acute postoperative and neuropathic pain. To further improve design of new drugs, the candidate will use drugs with good clinical properties (best efficacy and the fewest side effects in treating postoperative and neuropathic pain in animal surgical
14
Lidocaine
models) to define their binding sites in sensory neuron-specific Na+ channels transiently expressed in mammalian cells. It is hypothesized that this binding site is in areas responsible for use-dependent blockade, as there is no difference of the intrinsic affinity among different Na+ channel isoforms. With the use of site-directed mutagenesis, detailed structural information about the LA binding site in sensory-specific Na+ channels will be obtained by studying the effects of specific amino acid mutations on LA action and will help to direct and further refine drug design efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIRECT NEUROTOXICITY OF LOCAL ANESTHETICS Principal Investigator & Institution: Johnson, Michael E.; Mayo Clinic Coll of Medicine, Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 01-APR-2000; Project End 31-MAR-2004 Summary: The objective of this proposal is to determine the mechanism of direct neurotoxicity of spinal (intrathecal) lidocaine. Other local anesthetics have a risk of persistent lumbosacral neurotoxicity of approximately 1 in 10,000. Lidocaine at doses producing surgical anesthesia has an increased risk of approximately 1 in 200 via continuous spinal anesthesia, and approximately 1 in 1300 via single injection spinal anesthesia. Transient neurologic symptoms (TNS) of buttock and leg pain occur in 16-40 percent of patients receiving spinal lidocaine in multiple large studies. Lidocaine is also neurotoxic in an animal model that produces lower extremity anesthesia with 5 percent lidocaine, and in cell culture and in vitro nerve studies. To address the mechanism of this neurotoxicity, most studies will be conducted at the level of the single cell, using digitized video fluorescence microscopy, phase microscopy, and flow cytometry, with appropriate, specific, fluorescent probes. Immunoblotting and fluorogenic assays of fractionated cell lysates will also be utilized. The ND7 cell line, derived from rat dorsal root ganglion, will be used as a model system for neuronal injury. Two hypotheses will be tested as specific aims: (1) Lidocaine interferes with multiple mechanisms for maintaining normal cytoplasmic calcium (Ca2+cyt), causing an increase to toxic levels. Preliminary data show a marked effect of lidocaine to elevate Ca2+cyt (5-7 fold with 5 percent lidocaine; greater than 15 percent cell death within 60 min). The effect of lidocaine on possible mechanisms of Ca2+cyt elevation will be tested, including influx from extracellular buffer, release from endoplasmic reticulum, and release from mitochondria. The causal relationship of lidocaine-induced Ca2+cyt elevation to neurite injury, plasma membrane blebbing, and neuronal death by necrosis and apoptosis will be determined. (2) Lidocaine activates multiple mechanisms of mitochondrial injury. Preliminary data show a marked effect of lidocaine to decrease mitochondrial membrane potential deltapsi in whole cells. Potential mechanisms of decreased deltapsi by lidocaine will be tested: protonophoric mitochondrial uncoupling, inhibition of mitochondrial respiration, and induction of the mitochondrial permeability transition. The effect of lidocaine will also be tested on mitochondrially based mechanisms of cell death: release of mitochondrial cytochrome c, and caspase activation. The Ca2+cyt dependence of each mechanism of mitochondrial injury will be determined by experiments with and without Ca2+cyt clamped at a normal level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: ENHANCED CARDIAC SYMPATHETIC AFFERENT REFLEX IN CHF Principal Investigator & Institution: Wang, Wei; Physiology and Biophysics; University of Nebraska Medical Center Omaha, Ne 681987835
Studies
15
Timing: Fiscal Year 2004; Project Start 01-JUL-2004; Project End 30-JUN-2008 Summary: (provided by applicant): Heart failure is characterized by an elevation in sympathetic tone. The mechanisms responsible for the sympatho-excitation in heart failure are not completely understood. Recent studies from this laboratory indicate that the cardiac "sympathetic afferent" reflex is enhanced and the baroreceptor reflex is blunted in heart failure. The augmented cardiac sympathetic afferent reflex and the blunted baroreceptor reflex are mediated by increases in central angiotensin II in heart failure. So far the mechanism(s) responsible for these reflex interactions in the heart failure state are not completely clear. Based on preliminary data we hypothesize that the augmentation of the cardiac sympathetic afferent reflex is mediated by central angiotensin II and reactive oxidant stress in the heart failure state. To better understand the mechanisms responsible for augmentation of the cardiac sympathetic afferent reflex we propose the following specific aims: 1) To determine if reactive oxygen species mediates the augmented cardiac sympathetic afferent reflex by elevated central angiotensin II in heart failure; 2) To determine if the cardiac sympathetic afferent reflex blunts the baroreceptor reflex and if the blunted baroreflex in animals with heart failure is restored by removal of cardiac sympathetic afferent input with epicardial application of lidocaine or depletion of cardiac sympathetic afferent neurotransmitters by the epicardial application of the ultrapotent neurotoxin resiniferatoxin, and to determine if central angiotensin II and free radicals play an important role in the blunted baroreceptor reflex by activation of the cardiac sympathetic afferent pathway in rats with heart failure; 3) To determine if the cardiac sympathetic afferent reflex augments the chemoreceptor reflex and if the enhanced chemoreceptor reflex in animals with heart failure is restored by removal of cardiac sympathetic afferent input with epicardial application of lidocaine or resiniferatoxin and to determine if central angiotensin II and free radicals play an important role in the chemoreceptor reflex by activation of cardiac sympathetic afferents in rats with heart failure; and finally 4) To determine if exercise training normalizes the enhanced cardiac sympathetic afferent reflex, the augmented chemoreceptor reflex, and the blunted baroreceptor reflex in rats with heart failure by decreasing angiotensin II and free radicals. These reflex interactions regulate sympathetic outflow in heart failure. The abnormal sympatho-excitation in the heart failure state is likely to be mediated by a variety of peripheral inputs with important modulation by central substances. If the cardiac sympathetic afferent reflex and baroreceptor reflex are two of the reflexes which contribute to sympathetic activation in heart failure, a comprehensive understanding of neuro-humoral regulation of this reflex may result in more definitive and rational therapy targeted to the sympathetic nervous system in this disease state. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTIONAL IMAGING OF TINNITUS AND HEARING LOSS Principal Investigator & Institution: Lockwood, Alan H.; Professor of Neurology and Nuclear Medic; Neurology; State University of New York at Buffalo Suite 211 Ub Commons Buffalo, Ny 14228 Timing: Fiscal Year 2002; Project Start 01-JAN-1998; Project End 31-DEC-2002 Summary: The overall goal of this project is to develop a better understanding of the functional neuroanatomy of the auditory system and how this is affected by tinnitus, sensorineural hearing loss (SNHL) and phenomena associated with SNHL such as loudness recruitment. In preliminary studies, using positron emission tomography (PET) to measure cerebral blood flow (CBF), we have identified spontaneous neural activity in the central auditory system associated with tinnitus, evidence for plastic
16
Lidocaine
reorganization of central auditory systems, and links between sensory-motor systems and limbic and frontal brain regions that may mediate the emotional disability associated with tinnitus. We will broaden our successful preliminary approach by using statistical parametric mapping (SPM) to map CBF to focus on 5 specific aims: 1) What is the relationship between the intensity of an external tone and the degree of activation in the auditory cortex for subjects who have: (A) normal hearing, (B) loudness recruitment and (C) loudness recruitment plus tinnitus? 2) What effects do tinnitus and SNHL have on resting neural activity and what are the effects of high-frequency SNHL and tinnitus on the cortical frequency-place map? 3) What regions of the cerebral cortex are activated in patients who can modulate the loudness or pitch of their tinnitus with an oral-facial movement or eye movements? 4) Do lidocaine and residual inhibition reduce activity in regions of the brain activated by tinnitus? 5) What is the anatomical link between tinnitus and depression? This application of advanced imaging technology to study patients with communication disorders to investigate perception, and plasticity in the central auditory system should elucidate normal sensory processing of auditory information and how this is disturbed by tinnitus and SNHL. We expect to identify neural systems mediating tinnitus and related phenomena that will lead to the development of rational therapy targeted at affected neural areas. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTIONAL ORGANIZATION OF THE FRONTAL EYE FIELD Principal Investigator & Institution: Bruce, Charles J.; Professor; Neurobiology; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-MAR-1983; Project End 30-JUN-2004 Summary: (Adapted From The Applicant's Abstract): The proposed experiments continue an investigation of the functional organization of the primate frontal eye field (FEF) cortex and its role in the execution of voluntary eye movements. Previous studies of neurons in the saccadic region of FEF (FEFsac) find different combinations of activity related to saccades, visual inputs, and eye position as well as to behavioral states including memory and anticipation; similar activities related to smooth pursuit are found in FEF's smooth eye movement region (FEFsem). This new proposal initiates an investigation of how such activities and information are communicated between FEF and other areas that have strong reciprocal connections with FEF, demonstrated oculomotor function, and low thresholds for electrically eliciting eye movements. The parietal eye field (PEF) Iying in the lateral bank of the intraparietal sulcus (LIP) will be the principal structure studied. It is hypothesized that FEF receives visuospatial information coding possible saccadic targets from PEF, and that PEF receives activity coding impending saccadic eye movements from FEF. Communications between FEF and the oculomotor zone of the dorsal thalamus (termed thalamic eye field; TEF) will be the other pairing studied. It is hypothesized that FEF receives efferent copies of executing and completed saccadic eye movements from TEF, and that FEF efferents to TEF relay information about impending saccadic eye movements. For each of the pairings (PEFFEF and TEFFEF), 6 complementary experiments will be executed which Aim: 1) To determine what information/signals FEF sends to each target area by characterizing FEF neurons that are antidromically activated by electrodes in PEF and TEF. 2) To characterize information FEF receives from PEF and TEF by using the same methodology in reverse. 3) To analyze interareal communications by simultaneously recording from neurons with overlapping response fields in FEF and a target area, and analyzing possible causal relationships via cross-correlograms of their spiking during different behaviors. 4) To complement the cross-correlation analyses by directly
Studies
17
stimulating the FEF neuron being recorded with very low-intensity pulses (1-10 pA) at low frequency (1-3 Hz) and examining post-stimulus histograms (PSTHs) of the PEF/TEF neuron for significant excitation. Direct activation of the FEF neuron by the PEF/TEF site will be examined via the same methodology in reverse. 5) To further test any causal relation indicated by Aims 3 or 4 by deactivating the presumed effector site with muscimol or lidocaine and reanalyzing the functional properties of the neuron at the presumed target site. 6) To provide fine anatomical details of these reciprocal connections via microinjections of BDA and other tracers at physiologicallycharacterized sites, both in FEF and in PEF or TEF. Thus, the overall objective of this proposal is to begin to characterize the coordination of the distributed network above the midbrain that directs voluntary eye movements. The ultimate objective is to unite such data within a model of FEF function that accurately relates to normal and abnormal sensorimotor behavior, and accounts for the predictive, mnemonic, and cognitive facets of FEF function. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GLUTAMATE AND COCAINE CONDITIONED LOCOMOTION Principal Investigator & Institution: Hotsenpiller, Gregory; Neuroscience; Rosalind Franklin Univ of Medicine & Sci North Chicago, Il 60064 Timing: Fiscal Year 2002; Project Start 01-JUN-2002 Summary: The initial treatment of drug addiction in a hospital setting may proceed smoothly. However, upon return to the patient's environment. intense craving often occurs and leads to relapse. Both human and animal studies have revealed that such cravings result from the association of environmental stimuli with the state of psychoactive change in a Pavlovian manner. These conditioned stimuli are powerful enough to elicit dramatic increases in craving and activation of certain brain regions in human addicts as well as behavioral changes in animals formerly treated with drugs of abuse. To study conditioned responses that may elicit craving, we will use conditioned locomotion in rats. This refers to the ability of a stimulus alone to elicit locomotor activity after it is paired repeatedly with cocaine. A discrete cue (flashing light) will be used to enable precise investigation of the control this stimulus exerts over neurochemical changes. The hypothesis to be tested is that the expression of conditioned locomotion requires increased glutamate transmission in neural circuits involving the prefrontal cortex, basolateral amygdala and nucleus accumbens. Preliminary experiments demonstrated the acquisition of conditioned locomotion to the flashing light as well as robust conditioned responses 9 days after the last pairing with cocaine. Aim l will further characterize the time course and resistance to extinction of cocaine conditioned locomotion. Aim 2 will examine the anatomical regions necessary for expression of conditioned locomotion. We had planned to use Fos as a marker for neuronal activation but found that it was not induced by conditioning with the discrete flashing light cue. Thus, regions historically found to be relevant for conditioned drug responses will be examined through lesions and lidocaine inactivation. Using the information gained from Aim 2, Aim 3 will use microdialysis to measure glutamate levels in these regions during presentation of the conditioned cue. Determining the site and pharmacological nature of the conditioned change would provide information to guide treatment attempts to block expression of such responses and thus prevent relapse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
18
•
Lidocaine
Project Title: GLUTAMATE SENSITIZATION
TRANSMISSION
AND
AMPHETAMINE
Principal Investigator & Institution: Wolf, Marina; Associate Professor; Neuroscience; Rosalind Franklin Univ of Medicine & Sci North Chicago, Il 60064 Timing: Fiscal Year 2002; Project Start 01-SEP-1996; Project End 31-MAY-2005 Summary: (Verbatim from the Applicant's Abstract): Our working hypothesis is that drug addiction is a maladaptive form of glutamate-dependent plasticity. Our prior work has used behavioral sensitization as an animal model for intensification of drug craving. We have shown that glutamate transmission is required for the development of sensitization and that glutamate systems are dramatically altered in sensitized rats. This proposal will further characterize mechanisms underlying changes in glutamate transmission produced by amphetamine or by drug-associated environmental cues. Each of the aims focuses on a different aspect of glutamate's role in sensitization. Aim 1 is based on the hypothesis that the induction of sensitization requires potentiation of AMPA transmission within the ventral tegmental area (VTA). We propose to determine if this is mediated by Narp, a secreted immediate early gene product that clusters AMPA receptors at synaptic sites. Preliminary data show that Narp is elevated in VTA after both acute and repeated amphetamine treatment. Experiments will characterize Narp distribution in VTA, further examine the effects of amphetamine on its expression, and determine if the development of sensitization is prevented by chronic intra-VTA infusion of antisense oligodeoxynucleotides to Narp. Aim 2 builds on prior studies showing that repeated amphetamine decreases GluR1, GluR2 and NR1 levels in the nucleus accumbens (NAc), leading to changes in neuronal excitability that are hypothesized to mediate the long-term maintenance of sensitization. We will compare the persistence of these changes to that of behavioral sensitization, identify cell types within NAc that exhibit altered subunit expression, and examine amphetamine's possible effects on NR2 subunits and NR1 slice variants. Aim 3 will extend our studies of drug-induced plasticity to conditioned locomotion, a phenomenon that may provide insight into situational drug craving. We hypothesize that expression of conditioned locomotion requires increased activity of glutamate projections from prefrontal and cingulate cortices, or amygdala to the NAc. We will determine if the expression of conditioned locomotion is prevented by reversibly inactivating these regions with lidocaine or by blocking AMPA transmission. Microdialysis studies will directly examine the possibility that drug-associated cues activate glutamate transmission. Finally, we will determine if pharmacological treatments that reverse established locomotor sensitization also reverse conditioned locomotion. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTRAVENOUS LIDOCAINE IN TREATMENT OF NEUROPATHIC PAIN SYNDROMES Principal Investigator & Institution: Backonja, Miroslav; Associate Professor; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
19
Project Title: LIDOCAINE GEL FOR PAINFUL PERIPHERAL NEUROPATHY IN HIV Principal Investigator & Institution: Mcarthur, Justin C.; Professor of Neurology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002 Summary: The purpose of this study is to determine the safety, tolerability and efficacy of pain relief of lidoderm 5% gel for HIV-associated neuropathy. Painful peripheral neuropathies represent the most common neurological complication in patients infected with HIV. Painful distal sensory polyneuropathy (DSP) is the most common peripheral neuropathy in AIDS patients, occurring in about 20% to 35% of patients. The signs and symptoms of DSP include pain primarily in the feet, diminished primary sensory modalities in the feet, and decreased ankle reflexes with minimal foot weakness. The mechanism of DSP in AIDS is unknown. The incidence of DSP increases with advancing immunosuppression in later stages in the course of AIDS. The effectiveness of the new topical lidocaine formulations in the treatment of post-herpetic neuralgia pain suggest that these agents might be useful in treating the pain of HIV DSP. Because topical application of lidocaine has a very low potential for side effects or addiction, this type of treatment could become one of choice for a large number of patients. Lidocaine is an amide-type local anesthetic and is known to stabilize neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses. Lidoderm preparations, when applied to intact skin in post-herpetic neuralgia provides dermal analgesia through analgesic modulation of abnormally functioning fibers, rather than interfering with normal nerve fiber function. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: ACTION
LIDOCAINE/MORPHINE--PREDICTS
MEXILETINE/MORPHINE
Principal Investigator & Institution: Raja, Srinivasa N.; Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: Phantom limb pain and stump pain are common sequela of amputation. Most recent studies estimate 50-75% of amputees suffer from phantom pain early after amputation. Persistent phantom pain is difficult to treat and often worsens over time. Stump pain is less common and often decreases with time. The purpose of this study is to determine the efficacy of intravenous lidocaine and morphine infusions as compared to placebo on phantom and stump pain after amputation of extremities using a doubleblind cross-over randomized protocol. In addition, this study will examine whether these diagnostic infusions can serve as a predictive tool to evaluate the potential success of oral chronic therapy with slow release opioids and mexiletine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISMS OF DEEP BRAIN STIMULATION. Principal Investigator & Institution: Dostrovsky, Jonathan O.; Professor; University of Toronto Toronto, Ontario Toronto, on M5s 1A1 Timing: Fiscal Year 2002; Project Start 22-JAN-2001; Project End 31-DEC-2003 Summary: Electrical stimulation within the human brain is now an accepted method for the treatment of some types of movement disorders. However the mechanism of action of deep brain stimulation (DBS) is still not well understood. Two current hypotheses are
20
Lidocaine
that DBS produces inhibition of the neurons in the vicinity of the electrode by releasing GABA from inhibitory neurons or terminals pr terminals in the region or by causing a depolarization block of the surrounding neurons. Our proposal aims to obtain new information on the possible mechanisms of DBS. A newly developed dual microelectrode recording system will be employed during functional stereotactic surgery for implantation of DBS electrodes in the subthalamic nucleus (STN) and globus pallidus (GP) of Parkinson's disease patients. One of the two electrodes will be used for micro- or in some cases macro-stimulation and the effects of such stimulation assessed on the firing of neurons recorded at distances of 250 mum or more. Additionally, effects of high frequency and of lidocaine and muscimol microinjections into STN will be assessed on tremor, rigidity and bradykinesia. Preliminary studies using these methods have shown that stimulation in the GP very effectively inhibits the firing of most neurons in a manner that strongly suggests release of GABA. However, pilot studies in STN and motor thalamus, suggest that other or additional mechanism(s) might be involved. The findings of these studies focused on STN should provide new insights into the mechanisms underlying DBS and may lead to improvements in electrode design, electrode placement and optimal stimulation parameters thus leading to improvements in the therapeutic efficacy on this technique. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISMS OF RAPID RECEPTIVE FIELD REORGANIZATION Principal Investigator & Institution: Schwark, Harris D.; Biological Sciences; University of North Texas Box 305250 Denton, Tx 762035250 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2005 Summary: (provided by applicant)Changes in afferent activity to a sensory neuron can lead to changes in the neuron's receptive field. In the somatosensory system, subcutaneous injection of lidocaine into a neuron's receptive field results in marked reorganization of the receptive field, such that within minutes the neuron begins to respond to regions of skin outside the original receptive field. This process might reflect a mechanism by which the nervous system rapidly adapts to changes in the sensory environment (for example, tactile scanning of a surface might rapidly lead to reduced receptive field sizes and thus enhanced discriminability). Because it happens rapidly, receptive field reorganization appears to involve an "unmasking" of existing, ineffective synapses rather than sprouting of new connections. The neural mechanisms that underlie this synaptic unmasking are unknown. The proposed research will test a new model regarding the mechanism of unmasking: a decline in afferent activity changes the membrane conductance of a neuron such that distal synapses become "unmasked," and the neuron's receptive field enlarges. Specifically, the reduction in ongoing, spontaneous synaptic activity produced by subcutaneous lidocaine injection results in closure of membrane ion channels on the soma and proximal dendrites. This reduces membrane conductance and increases input resistance, increasing the electrotonic size of the neuron, As a result, previously ineffective synapses on distal dendrites become effective in producing membrane potential changes at the soma. This model will be tested in vivo on rat dorsal horn neurons by 1) producing RE reorganization while measuring input resistance in whole cell tight seal recordings, and 2) mapping receptive fields during extracellular recording and iontophoretic application of agents that open or close channels. Two different experimental paradigms will be used to accomplish the first aim. In the first, subthreshold inputs from the dorsal horn saphenous representation to the sciatic representation will be unmasked by applying lidocaine to the sciatic nerve. This design will permit analysis of intracellular responses that are synchronized with
Studies
21
electrical stimulation of the unmasked synapses. In the second experiment, subcutaneous injections of lidocaine will be made into a neuron's receptive field while monitoring the input resistance of the neuron. These studies will provide insights into a fundamental property of nervous system function - rapid adaptation to changes in the sensory environment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MODULATION OF TASTE RESPONSES BY THE TRIGEMINAL SYSTEM Principal Investigator & Institution: Simon, Sidney A.; Professor; Neurobiology; Duke University Durham, Nc 27710 Timing: Fiscal Year 2002; Project Start 01-APR-1991; Project End 31-JAN-2005 Summary: (Adapted from the Investigator's Abstract) Neural activity from receptors in the anterior tongue gives rise to a gustatory message that reflects the activation of both the taste and trigeminal somatosensory pathways. Currently not understood, and is the focus of this application, are the peripheral and central mechanisms regarding how the trigeminal (TG) system influences the taste system. The overall goals in this proposal are (1) to determine how compounds that activate TG neurons can modulate responses evoked from taste receptors cells (TRCs) and chorda tympani (CT) neurons, and (2) to quantify the contributions of the trigeminal somatosensory (mechanosenosry and nociceptive) pathways to the encoding of gustatory information in the insular cortex. It is proposed that, when activated, TG neurons will release neuropeptides, such as substance P and CCK, that will bind to receptors on TRCs and thereby modulate them. That in turn will modulate the activity of CT neurons to lingual applications of NaCl, acid, sucrose, and quinine. This hypothesis will be tested by activating the TG nerve electrically and chemically (e.g., with capsaicin, the pungent ingredient in hot pepper) and also by comparing CT responses before during and after the system injection of agonists and antagonists of substance P and CCK. A variety of methods (RT-PCR, immunocytochemistry, patch clamp, and measuring changes in intracellular calcium) will be used to determine whether CT modulation by TG activators such as capsaicin, is direct (on TRCs) and/or indirect via peptide release. Emphasis will be on identifying receptors for neuropeptides, capsaicin (VR1), and proton-gated channels in TRCs, lingual epithelium and geniculate ganglion neurons. To quantify the contribution of the TG somatosenory pathways to the cortical encoding of gustatory information, bundles of microelectrodes will be implanted in the primary gustatory (insular) cortex. Then, in lightly anesthetized rats, the simultaneous responses of populations of single insular neurons to a set of standard tastants will be measured before and after the selective inactivation of TG ganglion innervating the anterior tongue, a procedure that will simulate lingual nerve injuries. In addition, cortical-cortical influences on gustatory coding will be tested by reversibly inactivating the primary somatosensory cortex (SI). Information obtained from both the peripheral and cortical recordings will provide novel molecular, cellular and circuit mechanisms regarding the modulation of sensory information, and quantitative information regarding the contributions of the TG system to gustatory coding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: MOLECULAR INTERACTIONS
BASIS
OF
LIGAND/SODIUM
CHANNEL
Principal Investigator & Institution: Wang, Ging K.; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115
22
Lidocaine
Timing: Fiscal Year 2002; Project Start 06-SEP-1985; Project End 30-NOV-2003 Summary: The permeation pathway of the voltage-gated Na/+ channel encompasses a selectivity filter, and an activation gate. Upon binding, local anesthetics (LAs) block this permeation pathway whereas batrachotoxin (BTX) alters ion selectivity and causes persistent Na/+ channel opening. Our long-term objectives are (1) to understand better the structure/function relationship of receptor sites for LAs and for BTX in the alphasubunit of the voltage gated Na/+ channel and (2) to explore the interplay among the LA receptor, the BTX receptor, and the Na/+ permeation pathway. Such information will be beneficial for the design of therapeutic drugs. Two hypotheses will be tested: first, the receptors for LAs and for BTX change their conformations during state transitions and second, the LA receptor and the BTX receptor align in close proximity to each other within the Na/+ permeation pathway. Specifically, we will examine the structural basis of the static-ligand receptor interactions in the rat skeletal muscle Na/+ channel (SKM1), the successive changes in receptor sites during state transitions, and the functional roles of these receptors within the permeation pathway. Site-directed mutagenesis will be used to create mutants with point mutations at these two separate ligand binding sites. These mutants will be transiently expressed in human embryonic kidney cells. Both whole-cell and single-channel currents will be measured in order to obtain detailed kinetic information on the dynamic interactions between Na/+ channels and these ligands. A substituted- cysteine accessibility method will be used to scan the regions within or near the ligand binding sites that may change conformations during state transitions. Finally, the ion selected mutants will be examined to reveal the putative interactions between the selectivity locus and the receptors. Together, these studies should provide a better understanding of how BTX and LAs modulate the Na/+ permeation pathway at the molecular level as well as a clearer view of the dynamic interactions between these ligands and the alpha-subunit Na/+ channel. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOLECULAR PHARMACOLOGY OF CARDIAC ION CHANNELS Principal Investigator & Institution: Li, Ronald A.; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 01-AUG-1994; Project End 31-JUL-2004 Summary: The pore of the sodium channel binds a variety of clinically-important drugs (local anesthetics, antileptics and antiarrhythmics). The overall goal of this proposal is to define, at a detailed molecular and biophysical level, the determinants of drug binding to voltage-dependent Na channels. Substantial progress has been made during the initial funding period using a combination of mutagenesis, electrophysiology and quantitative modelling. We have discovered major differences in lidocaine sensitivity between cardiac and skeletal muscle sodium channels, defined interactions between local anesthetic block and slow inactivation gating processes, and mapped the crucial determinants for high-affinity tetrodotoxin block in the outer pore. We now propose to continue functional characterization of normal and mutant channels while obtaining hard structural information on the Na channel pore and related drug binding sites. The central goals of the application are the following: 1) to elucidate the origin of the differences in lidocaine sensitivity between cardiac and skeletal muscle Na channels; 2) to define determinants of selectivity, conductance and drug block which lie outside the conventional selectivity filter region; 3) to determine the impact of pore flexibility on gating and drug block; 4) to test a model of the secondary structure in which a pore helix precedes the selectivity filter in each domain; and 5) to solubilize and purify the Na channel alpha subunit and/or a truncated protein containing the critical determinants of
Studies
23
Na channel pore function and drug/toxin block. Given the central importance of sodium channels in normal physiology and in diseases of excitability (arrhythmias, epilepsy and myotonic disorders of muscle), this work promises not only to be of intrinsic biological interest but also of practical value in pharmacology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEURAL BASIS OF TASTE ELICITED INGESTION AND REJECTION Principal Investigator & Institution: Travers, Joseph B.; Associate Professor; Oral Biology; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2002; Project Start 01-SEP-1986; Project End 31-AUG-2004 Summary: (Adapted From The Applicant's Abstract): The objectives of this proposal are to determine the neural substrates in the rodent hindbrain through which gustatory stimuli guide ingestive behavior. The regulation of ingestive behavior is exceedingly complex, involving widespread regions of the central nervous system, but the basic regulatory function of taste to determine palatable from unpalatable stimuli is complete in the caudal brainstem. Anatomical studies suggest that polysynaptic pathways in the reticular formation serve as an interface between the gustatory region of the nucleus of the solitary tract and the oromotor nuclei that produce the consummatory responses of ingestion and rejection. Delineating this local circuitry is prerequisite to understanding how descending forebrain pathways further influence consummatory function. Specific subdivisions of the reticular formation including the lateral parvocellular and intermediate zones are hypothesized to mediate specific components of sensorimotor coordination. The proposed experiments combine several techniques to further understand the connectivity, neurochemistry and function of these reticular regions by (1) using double-labeling immunohistochemistry for identification of neurotransmitter phenotypes with concomitant increases in the expression of the immediate early gene cfos produced by gustatory stimulation, (2) assessing the connectivity and neurochemical phenotype of interneurons with projections to specific pools of lingual and masticatory motorneurons assayed with double labeling techniques that use the transynaptic properties of two genetically altered strains of pseudorabies virus, (3) determining the effects of reversible inactivation of small regions of the reticular formation following microinfusions of either lidocaine or antagonists to suspected neurotransmitters in the circuitry on ingestion and rejection elicited with intraoral stimulation and measured electromyographically from a subset of lingual, masticatory and pharyngeal muscles. Chronic diseases such as obesity, hypertension, and anorexia nervosa all involve ingestive dysfunction. Understanding the neurological basis of the fundamental biological decision to ingest or reject food will contribute to the eventual solution of these chronic debilitating disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NEURAL MECHANISMS OF SOCIAL RECOGNITION AND MEMORY Principal Investigator & Institution: Johnston, Robert E.; Psychology; Cornell University Ithaca Office of Sponsored Programs Ithaca, Ny 14853 Timing: Fiscal Year 2004; Project Start 01-AUG-1998; Project End 30-APR-2009 Summary: (provided by applicant): The goal of this proposal is to understand the neural mechanisms underlying communication and social behavior and related emotional and motivational states, particularly individual and kin recognition. A related goal of is to understand the neural mechanisms underlying these processes, especially the discovery
24
Lidocaine
of areas of the brain involved in social recognition and memory, emotional and motivational mechanisms related to recognition of familiar individuals and the consequent social behavior, and the sensory processes related to these abilities. The results will be relevant to understanding many types of mental and behavioral disorders that involve social interactions, such as autism and depression, personality disorders (e.g., antisocial, avoidant, paranoid or schizoid), social anxiety, social phobias and the effects of socially induced stress and post-traumatic stress. In addition, the findings will be relevant to disabilities due to stroke, head injury, or degenerative diseases, including Alzheimer's disease. The specific aims of the study are to use our extensive knowledge about social behavior and communication in hamsters as a model system to investigate the neural mechanisms of recognition of individuals, kin, and sex by odors. There are three specific goals. (1) Using immunohistochemistry to identify cells expressing immediate early genes, we will identify brain areas activated during response to familiar individuals and appropriate emotional responses to them. (2) Using microinfusion of lidocaine, we will determine which brain regions are necessary for individual and sex recognition and appropriate responses to such individuals. Brain areas of particular interest include the olfactory projection pathways, basolateral and medial amygdala, entorhinal cortex, peri-rhinal cortex, the hippocampus, and the subiculum. (3) The role of the main and accessory olfactory bulbs in processing information about individuals and kin and the role of social experiences in altering the patterns of activity in the bulb. These experiments will provide new and unique knowledge about the neural basis of social recognition, social memory, and the emotional and motivational responses caused by interactions with known individuals. These mechanisms are essential building blocks in the social behavior of non-human animals and humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROBIOLOGY OF SPATIAL LEARNING IN FOOD-HOARDING BIRDS Principal Investigator & Institution: Devoogd, Timothy J.; Professor; Psychology; Cornell University Ithaca Office of Sponsored Programs Ithaca, Ny 14853 Timing: Fiscal Year 2002; Project Start 01-APR-1997; Project End 31-MAR-2004 Summary: (Adapted from applicant's abstract): Learning and remembering spatial relations is an important human capacity. Many lines of evidence suggest that the hippocampus is essential for this form of learning, both in humans and in animals. However, much less is known of how spatial relations are encoded in the hippocampus or of how the hippocampus changes as learning of spatial relations occurs. This application will study the substrate for spatial learning using a novel animal model: seed storage in birds. Several species of birds hide large numbers of seeds and are able to retrieve them reliably weeks or months later. Several studies suggest that the hippocampus is necessary for the learning--it is larger in species that store than in related ones that do not, and birds that store are unable to retrieve if the hippocampus is lessoned. The P.I. and colleagues showed that the volume of the avian hippocampus increases in juveniles with the onset of storage and retrieval, and fluctuates seasonally in adults with use of seed storage and retrieval. This demonstrates that the structure of this complex neural network is modified in adulthood to allow for (or to encode) spatial learning. Furthermore, inactivating the hippocampus disrupts retrieval based on spatial cues. Experiments in the present proposal build on these findings. One series of experiments will measure changes in the structure and projections of hippocampal neurons from spring to fall, as the birds increase their storage and retrieval. Plastic
Studies
25
changes in anatomy will be compared to observations in a species that does not store food. We will try to determine the cause for the fall changes in behavior and neuroanatomy. A second series of experiments will examine hippocampal functioning. Two experiments will impair neuronal activity and look for changes in spatial learning or recall. A third will use immediate early gene expression as a marker of the neuronal activity associated with recall of spatial memories. It is intended to determine whether retrieving recent and remote spatial memories activates the same neural substrate. This proposal assesses several major aspects of the neurobiology of avian spatial learning. It searches for structural features related to the behavioral capacity, for long term structural change in the system related to seasonal changes in the frequency of the behavior, and for short term changes related to use. Each of these issues is closely related to human spatial learning, its neural substrate and its capacity for change. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROLOGY AGENDA Principal Investigator Washington, Dc 20059
&
Institution:
Delapanha,
Robert;
Howard
University
Timing: Fiscal Year 2002 Summary: SUBPROJECT ABSTRACT NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROLOGY AGENDA Principal Investigator & Institution: Marigan, Thomas G.; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2003 Summary: SUBPROJECT NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NEUROLOGY AGENDA Principal Investigator & Institution: Bartlett, John G.; Chief, Division of Infectious Diseases; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NEUROPHARMACOLOGY OF PAIN IN SPINAL CORD INJURY Principal Investigator & Institution: Sang, Christine N.; Assistant Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 15-JUL-2003 Summary: (provided by the applicant): Chronic central neuropathic pain syndromes develop in the majority of patients who sustain Spinal Cord Injury (SCI). Standard analgesic practices (including non-steroidal anti-inflammatory drugs, opioids, tricyclic antidepressants, anticonvulsants, and antispasmodics) have thus far been ineffective to relieve this chronic pain, which commonly can be severe. However, recent basic and clinical research with excitatory amino acid receptor antagonists opens the possibility for new treatments. Innovations are needed in analgesic clinical trials, such as: 1) the use of combination drug studies which target two or more biological mechanisms
26
Lidocaine
contributing to the pain syndrome; and 2) a better definition of clinical subsets to delineate biological mechanisms for subgroups of SCI pain syndromes. We will introduce each of these innovations in this pilot clinical trial. We and others have shown that NMDA receptor and sodium channel antagonists relieve pain in rats following experimental SCI and in patients with SCI. The overall goal of combining two therapies that target different putative pain mechanisms to, in part, reduce the sensitization of central neurons is to allow for the reduction of the dose of either agent to reach the desired outcome with fewer side effects (thereby widening the therapeutic ratio). We propose to evaluate various doses of the sodium channel antagonist lidocaine, when given in combination with varying doses of the NMDA receptor antagonist dextromethorphan, in patients with spontaneous pain and touch-evoked allodynia following SCI. Our primary aim is to determine the best dose-ratio of the two drugs in order to design efficiently the definitive phase III clinical trial evaluating the combination of these two classes of drugs, compared to placebo and each individual component drug. The overall objectives of this pilot grant are to improve the assessment of combination therapy by successfully incorporating a strategy to pick the best combination of doses of two component drugs and, in the process, collect preliminary data for establishing measures of efficacy and safety among the various dosecombinations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEW DERMAL ANESTHETICS Principal Investigator & Institution: Ciofalo, Vincent B.; Glsynthesis, Inc. Worcester, Ma 01605 Timing: Fiscal Year 2002; Project Start 27-SEP-1999; Project End 31-AUG-2004 Summary: (provided by applicant): Dermal anesthetics are used to anesthetize the skin of patients for various reasons, ranging from minor cutaneous surgery and needle inserts to skin grafts. The dermal anesthetic market is dominated by a single preparation, called EMLA (AstraZeneca), which consists of a eutectic mixture of lidocaine and prilocaine bases. EMLA?s principal drawback is a long onset time for dermal anesthesia, requiring up to two hours for full effect. The results of our Phase I studies demonstrate that we have arrived at compounds that are superior to EMLA in every respect. The new compounds offer faster onset of anesthetic activity, deeper local anesthesia, and longer duration of anesthesia than EMLA. We have selected a lead compound - racemic TAC-34 - and a backup compound - TAC-HP. (The enantiomers of TAC-34 possessed similar activity.) Both lead and backup compounds meet and exceed our original selection criteria. The goal of the phase II project is to acquire the data package needed to select the Candidate Drug, and to prepare the Investigational New Drug Application (IND) for submission to the Food and Drug Administration. Specific aims designed to meet this goal include: 1. to develop scale-up synthesis methods, analytical procedures, and formulations of both isomeric TAC-34 and the backup compound TAC-HP to further evaluate efficacy and toxicity for selection of the Candidate Drug; 2. to carry out the preclinical toxicity testing and to prepare the Chemistry, Manufacturing and Control information necessary to support the IND application for the Candidate Drug. After the first-in-man studies, we intend to license out this project to one of the pharmaceutical companies that has already expressed strong interest in this project. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
27
Project Title: NON-INVASIVE SELF ADMINISTRATION METHODOLOGY FOR MICE Principal Investigator & Institution: Hirsh, Jay; Professor; Biology; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Abuse of addictive drugs puts an enormous burden on society, yet many basic questions regarding drug craving pathways remain poorly understood. Current animal models of drug-self-administration are limited by technical difficulties associated with the invasive procedures required for small animals, particularly in the genetically tractable mouse. Here we describe the development of a non-invasive procedure for drug self-administration that is particularly suited for use in mouse. Preliminary studies conducted in the laboratory of Dr. David Stephens have shown that mice can be trained to self-administer an aqueous solution of cocaine delivered intranasally via an aerosol spray. Here we propose to replicate these results and further develop and apply these methods. Specific aims include: 1. Replication of the initial data generated in Stephens' laboratory, using newly constructed behavioral apparati in our own laboratory. 2. Controls to further validate the self-administration paradigm: these controls include use of related but nonaddicting substances such as lidocaine and measurement of additional physiological correlates of cocaine exposure. The measurements will include determination of serum and brain cocaine levels, and measurement of locomotor and heart-rate stimulation following cocaine exposure. 3. Application of this paradigm to mouse circadian mutants. These studies are based on the observation that mper 1 knockout mice show a lack of conditioned place preference to cocaine. We will study these mice as well as mper 1 and 3 knockouts, and mutants in several other circadian genes. These studies should address the question of whether the defect is specific to cocaine versus defects in more general reward pathways. 4. Screen candidate animals from the Neuromice.org recessive behavioral screen that show alterations in intitial cocaine responses. Initial screening for cocaine responsiveness is showing a large number of 'putants', 36 as of this writing. These mice will be made available to the scientific community even before they are fully characterized. We will obtain these lines when available as homozygotes and test them in our paradigm. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NPY AND NERVE INJURY-INDUCED TACTILE HYPERSENSITIVITY Principal Investigator & Institution: Porreca, Frank; Professor of Pharmacology and Anesthesio; Pharmacology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Substantial evidence supports the possibility that different neural mechanisms may underlie nerve injury- induced tactile and thermal hypersensitivity. Our recent preliminary data, for example, show that nerve-injury induced thermal hypersensitivity resolves at approximately 45 days post-injury, while tactile hypersensitivity persists apparently indefinitely (i.e., for at least more than 200 days). Lesions of the dorsal columns (DC) or microinjection of lidocaine into the n. gracilis on the side ipsilateral to the nerve-injury block nerve-injury induced tactile, but not thermal, hypersensitivity, supporting the possibility that tactile hyperresponsiveness may be mediated by large, myelinated fibers. In the absence of nerve injury, cells in the dorsal root ganglion (DRG) and in the n. gracilis either do not express neuropeptide Y (NPY), or express the peptide at very low levels. Following nerve injury, however, NPY -ir is markedly upregulated particularly in medium and large diameter DRG cells.
28
Lidocaine
Increased NPY -ir is also seen in the n. gracilis, as well as in the spinal dorsal horn. We propose testing the hypothesis that sustained nerve-injury induced tactile hypersensitivity results from the actions of upregulated NPY in afferent fibers which project to n. gracilis. Our preliminary data show that (a) nerve-injury induced upregulation of NPY -ir occurs in DRG cells and in projections to the ipsilateral n. gracilis through the DC, (b) NPY microinjected into the n. gracilis of uninjured animals produces ipsilateral tactile, but not thermal, hypersensitivity, (c) anti-NPY antiserum given into the n. gracilis ipsilateral to the side of nerve-injury reverses tactile, but not thermal, hypersensitivity and (d) microinjection of either of two NPY receptor antagonists into the n. gracilis ipsilateral to the side of nerve injury reverses tactile, but not thermal, hypersensitivity. Our hypothesis will be tested in Aim I by characterizing the time-course of NPY expression and determining if such expression and activity is consistent with early and/or late aspects of tactile hypersensitivity. Aim 2 will evaluate whether blockade of DC pathways or NPY expression can prevent the development of, or reverse existing, experimental neuropathic pain. Aim 3 will characterize the expression of NPY receptors in the DRG and in n. gracilis before and after nerve injury. Aim 4 will determine the possible contribution of post-synaptic dorsal column cells which project to n. gracilis to nerve injury- induced tactile hypersensitivity by determining if they receive inputs from NPY expressing fibers, and if they express NPY -ir and/or NPY receptors. Understanding the neural mechanisms underlying tactile hypersensitivity is highly significant as tactile allodynia in humans is the most devastating and difficult to manage symptom of clinical neuropathic pain. Selective reversal of injury-induced tactile hypersensitivity by NPY antagonists would have significant implications for treatment of the neuropathic condition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PAIN MODULATION AND VISCERAL STIMULATION Principal Investigator & Institution: Mason, Peggy; Associate Professor; Neurobiology/Pharmacology/Phys; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Visceral nociception, like cutaneous nociception, is subject to descending modulatory influences from the medullary raphe magnus (RM). However, little is known about if and how RM cells contribute to: 1) visceral stimulus evoked nocifensive reactions; and 2) visceral stimulus evoked suppression of cutaneous nociception. The proposed experiments use colorectal distension (CRD) as a model visceral stimulus to explore these issues. There are 6 aims:. Aim 1A: Identify the spinal trajectory of afferents that carry ascending CRD information to RM cells. Aim 1B: Identify the contributions of descending modulatory input, arising from RM and elsewhere, to CRD-evoked cardiovascular and visceromotor reactions. Aim 2: Determine the effect of RM cellular inactivation on behavioral reactions to CRD. Aim 3: Identify the physiological characteristics of neurons that discharge in a pro-nociceptive manner, with increasing excitatory responses to increasing intensities of CRD stimulation. Aim 4: Determine the spinal pathway taken by descending modulatory input, from RM and elsewhere, to the lumbosacral spinal cord. Aim 5: Establish the role of RM cellular activation in heterotopic suppression of cutaneous nociception by a noxious visceral stimulus. Aim 6: Aim 3: Identify the physiological characteristics of neurons that may subserve the antinociceptive effects of CRD stimulation. The proposed experiments will test the novel hypothesis that RM's effects on spinal nociception consists of a "pro-nociceptive" component that is necessary for the normal behavioral
Studies
29
reaction to a noxious visceral stimulus in addition to the better-studied "inhibitory modulation" component. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHARMACOLOGY OF CARDIAC SODIUM CHANNEL MODIFIERS Principal Investigator & Institution: Sheets, Michael F.; Professor of Medicine; Cardiovascular Research and Training Institute; University of Utah Salt Lake City, Ut 84102 Timing: Fiscal Year 2002; Project Start 01-APR-1990; Project End 31-DEC-2004 Summary: (Verbatim from the Applicant's Abstract): The long term objective of this laboratory is to understand the mechanisms of antiarrhythmic drug modification of the cardiac sodium channel. The goals of this proposal continue to pursue that objective by using an experimental approach that combines the measurements of Na channel gating currents, that are a direct measure of the movement of the channel's voltage sensors reflecting its molecular conformational states, with modification of Na channels by local anesthetic drugs and specific channel toxins to investigate antiarrhythmic drug interaction with the cardiac Na channel. We have applied this approach during the previous grant period, and have made important advances in the understanding of Na channel inactivation and its role in the mechanism of action by local anesthetic drugs. For the next grant period we expand upon our previous studies of cardiac Na channels with new studies on the Na channel's putative voltage-sensors associated with channel activation and inactivation and their modification by antiarrhythmic drugs. The experiments will use both wild-type and mutated cardiac Na channels heterologously expressed in tissue-cultured mammalian cells. Wild-type and mutant cardiac Na channel function will be probed by a combination of antiarrhythmic drugs, site-3 peptide toxins and MTS reagents. 1. Determine if modification of the Na channel gating charge-voltage (Q-V) relationship by lidocaine and its quarternary amine analogs results principally from inhibition of movement of the S4 of Domain III. 2. Demonstrate that the intracellular linker between domains III & IV (i.e. the inactivation lid) is not required for local anesthetic drug modification of the putative voltage sensors in cardiac Na channels. 3. Demonstrate that lidocaine and local anesthetic drugs do not cause gating charge to become "immobilized" similar to that found for fast inactivated wildtype hHla channels. 4. Determine if the S4 in domain III contributes to charge immobilization (i.e. the slow return of gating charge during repolarization) only after binding of an intact inactivation lid in Na channels. 5. Determine if the voltage sensor formed by the S4 segment in domains III contributes approximately 22 percent to the total Qmax of the cardiac Na channel. The results of the studies in this grant proposal should further our understanding of the molecular mechanisms of cardiac Na channel function, and help determine which components of the channel's voltage sensors are modified by lidocaine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: PHASE I STUDY OF TAXOTERE IN PATIENTS WITH ADVANCED MALIGNANCIES Principal Investigator & Institution: Lenz, Heinz Josef.; Associate Professor; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
30
•
Lidocaine
Project Title: PROCESSING OF BILATERAL INPUTS TO VESTIBULAR NUCLEUS Principal Investigator & Institution: Ariel, Michael; Associate Professor; Anatomy and Neurobiology; St. Louis University St. Louis, Mo 63103 Timing: Fiscal Year 2002; Project Start 01-JAN-2000; Project End 30-JUN-2005 Summary: (Adapted from the Investigator's Abstract) This is a revised application (R01 03894-01A) that describes novel experiments using an in vitro brain preparation with attached temporal bones to study the initial vestibular processing of the vertebrate brainstem. The Principal Investigator initially developed these innovating techniques to study visual inputs to reflex paths that stabilize the retinal image. In this grant application, only head rotation responses will be studied in the vestibular nuclei. Wholecell patch recordings of these responses will be examined before and after unilateral reversible lidocaine inactivation of the eighth nerve. Ipsilateral monosynaptic excitatory canal afferents converge onto neurons in the vestibular nucleus. A polysynaptic input is also thought to reach the same neurons from a contralateral canal with the corresponding axis of rotation. Vestibular nucleus neurons also display several response types during natural horizontal head rotation. Cells respond to motion to or away from the side of the recording, and their spike discharges can encode the head's velocity or acceleration. To elucidate the underlying neural circuitry of the vestibular nuclei, from the eighth nerve afferents and between the two nuclei, high-resolution patch recordings of individual synaptic events will be made as head rotation and electrical nerve stimulation evoke the excitatory and/or inhibitory pathways. Effects of synaptic drug applications will help identify the neurotransmitters involved in the monosynaptic and polysynaptic circuits. The membrane properties of the vestibular nucleus cells will be analyzed to see how they modify those synaptic inputs to yield the spike output of different vestibular response types. Redundant sensory input from both labyrinths is useful to improve vestibular sensitivity and to compensate for a unilateral loss. This project analyzes these bilateral inputs to gain an understanding of their role in the natural processing that results in a normal sense of balance or produces the feeling of vertigo during a pathological condition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: REENTRANT WAVEFRONTS IN VENTRICULAR FIBRILLATION Principal Investigator & Institution: Chen, Peng-Sheng; Pauline and Harold Price Chair in Cardia; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-JAN-2002; Project End 31-DEC-2002 Summary: Sudden cardiac death due to ventricular fibrillation (VF) is an important public health problem. However, our understanding of VF is limited. The broad, longterm objective of this research project is to elucidate the mechanisms of the generation and the maintenance of reentrant wavefronts in VF. The applicant has previously reported that the reentrant wavefronts are responsible for the generation VF in the canine model. In this grant application, the applicant proposes to study the reentrant wavefronts in VF both in vivo and in vitro. Computerized mapping studies will be performed in human patients and in dogs to document that reentrant wavefronts are present in Wiggers' stage II VF. Computerized mapping techniques and standard transmembrane microelectrode recording techniques will be used to study a novel in vitro model of sustained reentry. The following hypotheses will be tested: (1) Multiple reentrant wavefronts are present during Wiggers' stage II VF in humans, in normal healthy dogs, and in acutely ischemic dogs. (2) The reentrant wavefront circulates
Studies
31
around an area of functional conduction block (the 'core' of reentry) formed by cells undergoing graded responses but not full action potentials. There is no anatomical barrier at the core of reentry. (3) In normal tissue, the cycle length of the reentrant wavefront is longer than the wavelength of the reentrant wavefront. Therefore, an excitable gap is present. (4) The size of the core and the duration of the excitable gap are both important in determining the generation and maintenance of reentry. (5) Perturbations that decrease the size of the core decrease the volume of tissue that is needed to support a reentrant wavefront. Therefore, the smaller the size of the core, the easier to induce multiple reentrant wavefronts and VF. (6) Perturbations that decrease the excitable gap can protect the reentrant wavefronts from termination by competing wavefronts. Therefore, the smaller the excitable gap, the longer the life-span of the reentrant wavefronts, and the easier for VF to sustain itself. (7) The size of the core and the excitable gap of the reentrant wavefronts are both decreased by ischemia, predisposing the heart to ventricular fibrillation in this setting. These studies will further our understanding of the basic mechanisms of the generation and maintenance of VF in humans, and lead to new insights into prevention and treatment of sudden cardiac death. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF STRESS-INDUCED CORTICAL MONOAMINE ACTIVITY Principal Investigator & Institution: Forster, Gina L.; Biology; University of South Dakota 414 E Clark St Vermillion, Sd 57069 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2005 Summary: (provided by applicant): Variation in responses to stress can underlie or exacerbate psychiatric illness and social disorders. During stress, activity within the amygdala of the brain appears to alter monoamine neurotransmitter activity in the medial prefrontal cortex (mPFC), and neurotransmission within the mPFC contributes to the cognitive and endocrine processes associated with coping in stressful situations. Currently, how the amygdala alters neurotransmission in the mPFC is not well understood. Also, the specific role of the monoamine serotonin in the mPFC during stress is unclear. This project aims to determine how the neural output from the amygdala is integrated in other brain regions to alter mPFC monoamine activity, and also examine the behavioral consequences of this neural activity. It is anticipated that such knowledge will provide greater understanding of the neural circuitry thought to mediate stress, and advance research directed at designing pharmacological interventions to modulate stress responsiveness in psychiatric or social disorders. The proposed studies will initially map out brain pathways by which the amygdala stimulates monoamine activity in the mPFC, using in vivo chronoamperometry within a rat model. This will involve electrical stimulation of the amygdala in anaesthetized rats, with resultant monoamine release recorded from the mPFC before and after transient blockade of pathways with the sodium channel blocker lidocaine. Subsequent experiments using a similar methodology will determine the involvement of the neurohormone corticotrophin releasing factor (CRF) in activating these pathways as CRF increases during stress, and is a major neurotransmitter used by the output neurons of the amygdala. Specifically, the effects of a CRF blocker on amygdala-elicited changes in mPFC monoamine release will be assessed. It is expected that results will determine whether targeting CRF release or transmission in the brain will provide a useful and feasible direction for pharmaceutical therapeutics. The final experiments will assess whether pharmacological alterations (both increases and decreases) in serotoninergic
32
Lidocaine
activity within the mPFC change behavioral responsiveness towards an acute stressor, using microdialysis in freely moving rats. Positive findings here will provide essential information as to the role of serotonin in stress, and offer options for the 'fine-tuning' of pharmacological therapeutics to limit stress responsiveness and aid rehabilitation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RVM CCK AND NEUROPATHIC PAIN Principal Investigator & Institution: Lai, Josephine; Professor; Pharmacology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2004; Project Start 05-JUL-2004; Project End 31-MAY-2008 Summary: (provided by applicant): Recent evidence suggests that processes that initiate neuropathic pain may differ from those that maintain such pain. That persistent neuropathic pain states require descending facilitation arising from the rostral ventromedial medulla (RVM) is suggested by the finding that lidocaine injected into the RVM effectively blocks experimental neuropathic pain at post-in jury day 6 (and later), but not at post-injury day 3. Onset of this descending facilitation may arise from activity of RVM cells that express mu opioid receptors, since either a selective lesion of these cells with a saporin-mu opioid conjugate or surgical lesion of the dorsolateral funiculus (DLF), a descending fiber pathway to the dorsal horn, prevents and reverses the expression of neuropathic pain. These findings implicate a time-dependent activation of descending facilitatory processes in the RVM following injury to maintain, rather than initiate, abnormal pain. The nature of the RVM neuroplasticity that drives such pain is unknown. One clue to this mechanism is our observation that RVM microinjection of a CCK 2 receptor antagonist produces a reversible blockade of established neuropathic pain. In addition, microinjection of CCK-8(S) into the RVM of uninjured rats produces tactile and thermal hypersensitivity reminiscent of states of nerve-injury induced pain. These effects are prevented by lesions of the DLF, or of RVM cells expressing mu opioid receptors, suggesting the possibility that RVM CCK may promote injury- induced pain by activating RVM neurons that are phenotypically defined by the expression of mu opioid receptors. For these reasons, we hypothesize that nerve-injury results in a timerelated increase in RVM CCK activity to drive descending facilitation and to maintain nerve-injury induced pain. This hypothesis will be tested by the following specific aims. Aim 1 will characterize (a) the basal CCK activity in the RVM, and changes in CCK activity in response to mechanical and thermal cutaneous inputs in naive rats, and (b) the time-dependent nature of CCK activity in the RVM following nerve injury. Specifically, basal CCK release, and CCK release in response to mechanical and thermal cutaneous inputs in the RVM will be measured at early and late time points after spinal nerve ligation injury. Aim 2 will identify the CCK receptor(s) at which RVM CCK may act to drive descending facilitation. The functional roles of CCK and CCK2 receptor types in the RVM pre- and post-injury will be evaluated pharmacologically by microinjection of selective CCK receptor antagonists. The spatial distribution of the CCK receptors will be analyzed by semi-quantitative in situ hybridization and receptor autoradiography. Aim 2 will also examine the possibility that CCK receptors may colocalize with mu opioid receptors in RVM neurons. The proposed experiments will reveal some features of the RVM plasticity that may be critical in maintaining neuropathic pain. As patients who suffer from neuropathic pain are likely to seek treatment long after the precipitating injury has occurred, understanding the mechanisms that maintain the neuropathic state will be essential for the development of rational therapeutic interventions. In this regard, the proposed experiments may reveal an important role for CCK receptor antagonists as therapy for neuropathic pain.
Studies
33
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RVM CCK, PAIN, AND OPIOID TOLERANCE Principal Investigator & Institution: Vanderah, Todd W.; Pharmacology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2007 Summary: (provided by applicant): Recent evidence suggests that, in addition to analgesia, opioids produce unexpected, paradoxical pain in both preclinical and clinical settings. In the case of morphine, opioid-induced pain limits not only acute antinociceptive efficacy but also appears to promote the decreased antinociception seen with sustained exposure (i.e., behavioral opioid antinociceptive tolerance). Manipulations which block morphine-induced pain also block the decrease in antinociceptive potency seen with sustained morphine, suggesting that opioid-induced pain may represent an important component of antinociceptive tolerance to this drug. Among the manipulations which block morphine-induced pain and antinociceptive tolerance are rostral ventromedial medulla (RVM) injection of lidocaine and bilateral lesions of the dorsolateral funiculus (DLF) suggesting a tonically active descending pain modulatory (facilitatory) system which maintains morphine-induced pain and antinociceptive tolerance. Whether the observations made with morphine extend to other agonists of differing opioid receptor selectivity is not known. This proposal hypothesizes that morphine enhances cholecystokinin (CCK) release in the RVM which then promotes opioid-induced pain and antinociceptive "tolerance." Supporting this possibility are preliminary data which show that RVM CCK produces "pain" in animals not exposed to opioids which is blocked by DLF lesions. Additionally, acute and sustained morphine increases release of CCK-LI in the RVM. Three aims will test this hypothesis. Aim 1 will investigate the release of CCK-LI in the RVM following acute local or systemic morphine, the time-course of this effect and the opioid receptor mediating this effect. Aim 2 will address the actions of sustained systemic morphine in regulating enhanced RVM CCK-LI release, its time-course and correlation to pain, and the opioid receptor mediating enhancement of RVM CCK-LI release during sustained opioid delivery. Aim 3 determines if an RVM CCK antagonist prevents the development of opioid induced pain and prevents or reverses spinal or systemic opioid antinociceptive tolerance. These studies will determine if opioid-induced release of RVM CCK represents the tonic driving force which maintains morphine- or opioidinduced pain and antinociceptive tolerance. The studies offer new insights into physiological mechanisms of opioid tolerance and strategies which might be employed to prevent opioid-induced pain and antinociceptive tolerance. These approaches may allow for sustained efficacy of morphine or opioids and their use in the treatment of chronic or prolonged pain states. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: RESEARCH
SEATTLE-KING
COUNTY
CENTER
FOR
RESUSCITATION
Principal Investigator & Institution: Kudenchuk, Peter J.; Medicine; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2004; Project Start 01-SEP-2004; Project End 30-APR-2009 Summary: (provided by applicant): This application is the response of the University of Washington and Emergency Medical Services (EMS) of Seattle and King County, WA to the RFA HL-04-001 entitled "Clinical Research Consortium to Improve Resuscitation
34
Lidocaine
Outcomes." The EMS of Seattle and King County have a programmatic focus on cardiac arrest and life-threatening trauma and continue to make important contributions to each link in the American Heart Association's "chain of survival," as well as important advances in trauma management. An experienced group of internationally renown investigators, along with the infrastructure and resources provided by the University with broad community support, are committed to advancing resuscitation science through the training of young investigators in the field of prehospital emergency care and the conduct of clinical trials. This application sets forth 2 research proposals pertaining to management of out-of-hospital cardiac arrest, and life-threatening trauma that exemplify the insights and expertise of the assembled team of researchers and the quality of the local prehospital care system. The cardiac arrest proposal is a prospective, randomized, double-blind comparison of amiodarone, lidocaine and placebo in out-ofhospital ventricular fibrillation that will assess the impact of such treatment on neurologically functional survival. The trauma protocol is a similarly designed comparison of 7.5% hypertonic saline in dextran, 3% saline, and conventional fluid resuscitation on mortality and neurologic function after blunt traumatic injury associated with hypovolemic shock. Each proposal will enroll between 400-500 patients over a two year period, and will have enhanced statistical power to establish their important endpoints through participation of a Consortium of clinical research centers. Finally, a Clinical Research Skills Development Core is proposed, founded on the rich research and teaching environment of the University and prehospital care system to foster and direct the training of young investigators from a variety of disciplines in resuscitation research. (End of Abstract) Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SODIUM CHANNEL BLOCKERS AS INHIBITORS OF PROSTATE CANCER Principal Investigator & Institution: Brown, Milton L.; Assistant Professor; Chemistry; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2004; Project Start 01-MAY-2004; Project End 30-APR-2009 Summary: (provided by applicant): Recently, the invasive and metastatic potential of prostate cancer was correlated with the expression of a voltage-gated sodium channel in human and rat prostate cancer (PCa) cell lines. A 260-kd protein, corresponding to a voltage-gated sodium channel, was identified in PC-3 and highly metastatic Mat-LyLu PCa cell lines. This sodium channel isotype was inhibited by tetrodotoxin (TTX) and identified as a voltage dependent channel. Further investigation into the relationship between human prostate expressed Na+ channel and the invasive phenotype found that TTX reduced the invasiveness of PC-3 cells by 31% (P = 0.02). Since metastatic prostate adenocarcinoma is the second most common cause of cancer-related deaths among men in North America, a large void in effective treatment regimens still exists. We hypothesize that sodium channel modulating agents will be effective in preventing or limiting PCa growth and/or metastasis. With this in mind, we propose to evaluate novel sodium channels blockers as inhibitors of LNCaP, C4-2, PC3, PC-3M and DU145 human PCa cell lines. In this new investigator proposal, we demonstrate using thymidine uptake, crystal violet growth assays, MTT, and soft agarose assays that our lead compounds inhibit androgen dependent and independent PCa cell lines. Preliminary data from our laboratory identified two classes of novel inhibitors that have potent cellular inhibitory effects at 40 micromolar when tested over 7 days of treatment. Furthermore, these analogues were more effective at inhibiting all PCa cell lines tested to date as compared to known sodium channel blocking agents like phenytoin and
Studies
35
lidocaine. Altogether, this work lays the framework for the evaluation of these novel compounds in vivo. We are encouraged by these preliminary results and specifically aim to: 1) synthesize novel analogs of the active leads designed with systematic changes to evaluate, 2) evaluate the electrophysiological properties of the novel analogs for sodium channel activity, 3) evaluate the novel analogs for inhibition of human prostate cancer cell line (LNCaP, C4-2, PC3, PC-3M and Du-145) growth, tumorigenic and metastatic potential using in vitro model systems and 4) evaluate the novel active analogs for inhibition of human prostate cancer growth, tumorigenic and metastatic potential using in vivo model systems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STUDY OF ACTIVITY-DEPENDENT SYMPATHETIC SPROUTING Principal Investigator & Institution: Zhang, Junming; Associate Professor; Anesthesiology; University of Arkansas Med Scis Ltl Rock Little Rock, Ar 72205 Timing: Fiscal Year 2004; Project Start 04-MAY-2004; Project End 30-APR-2009 Summary: (provided by applicant): The overall goal of our research is to investigate the mechanisms underling sympathetic sprouting and its correlation with ectopic, spontaneous activity originating from axotornized sensory neurons or injured peripheral axons (neuroma). After peripheral axotomy, sympathetic axons sprout into the lumbar dorsal root ganglia (DRGs), a major phenomenon implicated in neuropathic pain (e.g., complex regional pain syndrome [CRPS]). Although there is evidence that certain glial-cell-derived neurotrophins are involved in the sympathetic sprouting, the causal factor that triggers, and possibly guides, the sprouting of sympathetic nerve endings remains largely unknown. However, evidence exists that sympathetic sprouting is associated predominately with large- and medium-sized sensory neurons, which often present with high frequency and/or bursting discharges after nerve injury. Results from our preliminary study revealed that systemic lidocaine (a Na* channel blocker) significantly reduced the extent of sympathetic sprouting, whereas systemic administration of 4-aminopyridine (4-AP, a K+ channel blocker), which enhances spontaneous activity, increased the sprouting. We hypothesize that injury of the peripheral nerve or the DRG causes high frequency and/or bursting discharges in largeand medium-sized DRG neurons that trigger the sprouting of sympathetic nerve fibers possibly through the enhanced expression of neurotrophins from satellite glial cells. Using animal models of experimental neuroma combining with electrophysiological, immunohistochemical and Western blot techniques, we will test our hypothesis via the following 3 Specific Aims. Specific Aim 1. Examine whether sympathetic sprouting in DRGs with peripheral axotomy shows any preference for spontaneously active neurons with high frequency and/or bursting discharges or hyperexcitability. Specific Aim 2. Determine whether sympathetic sprouting may be evoked by spontaneous activity in DRGs without axotomy. Specific Aim 3. Assess the role of glial cell-derived neurotrophins in activity-dependent sympathetic sprouting. If a relationship among spontaneous activity, neurotrophins, and sympathetic sprouting is identified, then new therapeutic approaches involving pharmacological modulation of spontaneous activity could be developed to suppress the hyperexcitability of sensory neurons. Such therapies could provide more effective non-opioid analgesia to patients with neuropathic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: THE MOLECULAR BASIS OF LOCAL ANESTHESIA Principal Investigator & Institution: Balser, Jeffrey R.; Professor; Anesthesiology; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917
36
Lidocaine
Timing: Fiscal Year 2002; Project Start 01-AUG-1997; Project End 31-JUL-2005 Summary: (Verbatim from the applicant's abstract) Sodium (Na) channels, the principle target of local anesthetic agents, change their conformational state in response to membrane potential. Depolarization increases the intensity of the drug-receptor interaction nearly 100-fold. While this phenomenon imderlies the broad therapeutic efficacy of local anesthetics, these voltage-dependent interactions also provoke lifethreatening side effects (arrhythmias, seizures). Clarifying this dynamic modulation of the drug-receptor interaction will complement new data identifying local anesthetic binding domains, and will improve the design of these compounds. A number of distinct Na channel loci that mediate intrinsic conformational changes (fast and slow inactivation) also modulate local anesthetic action, consistent with the original proposal (the Modulated Receptor Hypothesis) that local anesthetic binding affinity is governed by conformational state. A corollary prediction is that local anesthetics, when bound, should induce the Na channel to occupy higher-affinity conformational state(s). Recent work reveals that intrinsic Na channel conformational changes involve sizeable molecular motions that modify the architecture of the pore. We propose that local anesthetics function as allosteric effectors to induce intrinsic conformational changes in the pore, analogous to ligand effects on allosteric enzymes. Our studies will examine the gating conformational properties of heterologously-expressed Na channels containing engineered cysteine residues using patch-clamp methods. Using methanethiosulfonate reagents, we will examine how slow inactivation changes the sulfhydryl accessibility of amino acid residues in the outer pore region in response to local anesthetic binding. In addition, we will examine the linkage between the earliest phase of depolarizationinduced block and motion of the charged S4 segments, with a view to linking motion of these segments to conformational changes in the outer pore. Finally, we will utilize a disulfide trapping approach to constrain the interdomain distance changes induced by local anesthetic block, and will interpret these using a new molecular model of the Na channel pore. Our studies will illuminate the dynamic structure of the Na channel pore, and will facilitate the design of more targeted and less toxic local anesthetic agents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TOPICAL ANESTHESIA EFFECTS ON UPPER AIRWAY COLLAPSE Principal Investigator & Institution: Marcus, Carole L.; Professor of Pediatrics; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002 Summary: The childhood obstructive sleep apnea syndrome (OSAS) is a common and serious pediatric disease. Previously, we have shown that children have a less collapsible upper airway than adults. This is probably due to differences in neuromotor control of the upper airway. We previously showed that children have a stronger ventilatory drive than adults. Thus, it is probable that children have an increased central nervous system response to stimulation of the upper airway nerves. This may be due to either increased afferent or efferent activity of upper airway reflexes. We hypothesized that children have increased upper airway neuromotor tone secondary to increased upper airway sensory reflexes. In this proposal, we will determine the critical upper airway closing pressure (Pcrit), an objective measure of upper airway collapsibility. The afferent limb of the upper airway response will be compared in children versus adults during sleep, by measuring Pcrit before and after the use of topical anesthesia (lidocaine) to block sensory nerves. This study will advance our understanding of the normal developmental changes in upper airway physiology, thus leading to an
Studies
37
improved understanding of the pathophysiology of the childhood obstructive sleep apnea syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANESTHESIA
TRIGEMINAL
SYSTEM
PLASTICITY
DURING
FACIAL
Principal Investigator & Institution: Nicolelis, Miguel A.; Associate Professor; Neurobiology; Duke University Durham, Nc 27710 Timing: Fiscal Year 2002; Project Start 01-SEP-1994; Project End 30-JUN-2005 Summary: The long term goal of the project is to elucidate the neural circuit mechanisms underlying the immediate sensory reorganization of subcortical and cortical sensory maps induced by local anesthesia (e.g. dental anesthesia) of the face. We refer to this as "acute plasticity). The working hypothesis is that adult somatosensory representations are not "hard-wired," but instead are defined by dynamic and distributed interactions between feed-forward and feedback projections which converge on neurons located at all processing levels of the somatosensory system. According to this hypothesis, lesions at any part of the sensory system should induce an immediate reorganization across all subcortical nuclei and cortical areas that belong to the system. We will test the hypothesis by investigating the role of cortical feedback projections in the concurrent reorganization process observed in multiple thalamic and brainstem nuclei after a subcutaneous injection of the local anesthetic lidocaine. Simultaneous recording of up to 135 single brainstem, thalamic and cortical neurons will be made in the same rat while its somatosensory cortex is reversibly inactivated before, during and after the induction of reversible peripheral deafferentation. This approach will allow us to establish correlations between concurrent reorganizations occurring at each level and to quantify the effects of cortical inactivation on this process. The prediction is that cortical inactivation will reduce the spatiotemporal extent of the subcortical reorganization and that this effect will be proportional to the density of cortical feedback converging in each subcortical nucleus. These experiments will provide fundamental information concerning the circuit mechanisms that underlie the genesis of sensory representations and their ability to be shared by experience, two central areas of investigation in modern neuroscience. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TZD TREATMENT OF COCAINE TOXICITY Principal Investigator & Institution: Weinberg, Guy L.; Anesthesiology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2004; Project Start 01-MAY-2004; Project End 30-APR-2006 Summary: (provided by applicant): Abuse of cocaine, a local anesthetic, is associated with widespread and costly adverse public health effects. It is used regularly by more than a million Americans and can cause immediate and long-term medical problems, including severely elevated blood pressure, dangerous irregularities in heart rhythm, heart attack, heart failure and possibly atherosclerosis. Unfortunately, no specific therapy exists to treat either the acute or chronic adverse cardiac effects of cocaine abuse. Clinically used local anesthetics, such as lidocaine, impair function of mitochondria, the intracellular organelles that synthesize adenosine triphosphate (ATP), the molecule that serves cells' energy needs. This effect includes reduction of the mitochondrial proton-motive force, which may contribute to local anesthetic toxicity. Interestingly, the cytotoxicity of lidocaine is reduced by coincubating cells with
38
Lidocaine
members of the thiazolidinedione (TZD) class of Peroxisome Proliferator Activated Receptor-gamma (PPARg) agonists, drugs commonly used to treat adult-onset diabetes. We have found that TZDs also increase cellular glucose uptake and lactate production and increase the mitochondrial proton-motive force. In preliminary studies, we find that TZDs protect against cocaine-induced cell death and cardiac diastolic dysfunction. These novel observations suggest that improved metabolism could be considered for treatment of acute cocaine toxicity. The major goal of this proposal is to test the hypothesis that TZD-induced improvements in cellular energy state will rescue cells from metabolic inhibition by cocaine. This research will define the dynamics, biochemistry and mechanisms of TZD salvage from cocaine-induced toxicity, looking specifically at the time course and type of cell death caused by cocaine, and whether altered nitric oxide levels or activation of programmed cell death (apoptosis) play a role. We will also establish an isolated heart model to study the potential for clinical application of TZDs to treat acute cocaine cardiac toxicity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VULVAR VESTIBULITIS TRIAL: DESIPRAMINE-LIDOCAINE Principal Investigator & Institution: Foster, David; Obstetrics and Gynecology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Studies are proposed for the subtype of vulvodynia known as vulvar vestibulitis. The first major aim of this application is to conduct a randomized, placebo-controlled, double-blinded clinical trial to study the clinical efficacy of four medical regimens: topical lidocaine, oral desipramine, topical lidocaine combined with oral desipramine and placebo. The efficacy of standard treatments for vulvar vestibulitis proven by randomized, placebo-controlled, blinded clinical trials has not been assessed. The tricyclic class of antidepressants, represented by desipramine, have gained empiric acceptance for the treatment of vulvar vestibulitis, although favorable therapeutic results have been reported by only a few retrospective studies or uncontrolled clinical trials. Although the precise mechanism of action remains undefined for tricyclic antidepressants, a "central" action through the dorsal horn and brain stem has been suggested. In contrast to oral desipramine, the long-term, topical application of lidocaine may act through a "local" mechanism. This randomized, placebo-controlled, double-blinded clinical trial is designed to determine whether "local" or "centrally-acting" treatments alone, or in combination are efficacious in treating vulvar vestibulitis. Outcome measures of success will include reduced overall pain, reduced pain to touch, reduced pain to standardized mechanical stimuli, increased painfree intercourse, improved sexual function, improved quality-of-life as measured by psychometric tests, and adherence to active drug regimens. The second major aim of this application is to study the relationship among genetic polymorphisms of the IL-1 Receptor Antagonist locus, tissue levels of pro-inflammatory cytokines, and response to treatment of vulvar vestibulitis. Pro-inflammatory cytokines, such as interleukin-I beta (IL-1 beta) and tumor necrosis factor alpha (TNF-alpha), are secreted from a local cellular source and accumulate above normal levels in the region of the hymeneal ring. Recent genetic analysis finds a 53% homozygosity for allele 2 IL-1 Receptor Antagonist (IL-1 RA*2) in cases of vulvar vestibulitis, in contrast to 8.5% homozygosity in asymptomatic women. Furthermore, the IL-1 RA*2 allele has been linked to increased production of IL-1 beta in vitro. In our second aim, we will determine whether these in vitro results can be extrapolated to clinical cases of vulvar vestibulitis. Using samples from our clinical trial, we will assess the relationship between homozygosity for IL-1
Studies
39
RA*2, tissue levels of IL-1 beta, and TNF-alpha, and response to treatment. In summary, this project will allow us to answer several important questions about vulvar vestibulitis. Is medical treatment effective? Is centrally-acting or locally-acting treatment equally effective or is one superior to the other? Is there any benefit from combined local and systemic treatments? And finally, do genetic characteristics and tissue cytokine concentrations influence treatment response? Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “lidocaine” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for lidocaine in the PubMed Central database: •
Comparison of lidocaine and compression for velvet antler analgesia in wapiti. by Woodbury MR, Caulkett NA, Wilson PR.; 2002 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=339760
•
Effect of Lidocaine Hydrochloride on Membrane Conductance in Mammalian Cardiac Purkinje Fibers. by Arnsdorf MF, Bigger JT Jr.; 1972 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=292389
•
Effect of Lidocaine on the Electrophysiological Properties of Ventricular Muscle and Purkinje Fibers. by Bigger JT Jr, Mandel WJ.; 1970 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=322445
•
Electroconvulsive Shock and Lidocaine Reveal Rapid Consolidation of Spatial Working Memory in the Water Maze. by Bohbot V, Otahal P, Liu Z, Nadel L, Bures J.; 1996 Apr 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=39478
•
Pharmacokinetics and tolerance of ceftriaxone in humans after single-dose intramuscular administration in water and lidocaine diluents. by Patel IH, Weinfeld RE, Konikoff J, Parsonnet M.; 1982 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=182052
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
40
Lidocaine
•
Regional Lidocaine Infusion Reduces Postischemic Spinal Cord Injury in Rabbits. by Apaydin AZ, Buket S.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=101170
•
Reversal of lidocaine effects on sodium currents by isoproterenol in rabbit hearts and heart cells. by Lee HC, Matsuda JJ, Reynertson SI, Martins JB, Shibata EF.; 1993 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=288011
•
Transport of Propranolol and Lidocaine through the Rat Blood-Brain Barrier. PRIMARY ROLE OF GLOBULIN-BOUND DRUG. by Pardridge WM, Sakiyama R, Fierer G.; 1983 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=436947
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with lidocaine, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “lidocaine” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for lidocaine (hyperlinks lead to article summaries): •
A comparison of buffered lidocaine versus ELA-Max before peripheral intravenous catheter insertions in children. Author(s): Luhmann J, Hurt S, Shootman M, Kennedy R. Source: Pediatrics. 2004 March; 113(3 Pt 1): E217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14993579
•
A comparison of hyperbaric 1% and 3% solutions of small-dose lidocaine in spinal anesthesia. Author(s): Kawamata YT, Nishikawa K, Kawamata T, Omote K, Igarashi M, Yamauchi M, Sato K, Nakayama M, Namiki A. Source: Anesthesia and Analgesia. 2003 March; 96(3): 881-4, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12598278
6
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
Studies
41
•
A randomised study of lidocaine and prilocaine for spinal anaesthesia. Author(s): Ostgaard G, Hallaraker O, Ulveseth OK, Flaatten H. Source: Acta Anaesthesiologica Scandinavica. 2000 April; 44(4): 436-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10757577
•
Acute aphesia following tourniquet release in intravenous regional anesthesia with 0.75% lidocaine. Author(s): Cherng CH, Wong CS, Ho ST. Source: Regional Anesthesia and Pain Medicine. 2000 March-April; 25(2): 211-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10746541
•
Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Author(s): Memis D, Turan A, Karamanlioglu B, Pamukcu Z, Kurt I. Source: Anesthesia and Analgesia. 2004 March; 98(3): 835-40, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14980948
•
Aerosolization of lidocaine. Author(s): Mackenzie I. Source: Anesthesiology. 2000 April; 92(4): 1201-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10763067
•
Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena. Author(s): Estebe JP, Delahaye S, Le Corre P, Dollo G, Le Naoures A, Chevanne F, Ecoffey C. Source: British Journal of Anaesthesia. 2004 March; 92(3): 361-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14970135
•
An evaluation of 4% prilocaine with 1:200,000 epinephrine and 2% mepivacaine with 1:20,000 levonordefrin compared with 2% lidocaine with:100,000 epinephrine for inferior alveolar nerve block. Author(s): Hinkley SA, Reader A, Beck M, Meyers WJ. Source: Anesthesia Progress. 1991 May-June; 38(3): 84-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1814249
•
An objective comparison of intrathecal lidocaine versus fentanyl for the treatment of lower extremity spasticity. Author(s): Chabal C, Jacobson L, Schwid HA. Source: Anesthesiology. 1991 April; 74(4): 643-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2008943
42
Lidocaine
•
An unusual symptom of lidocaine allergy. Report of a case. Author(s): Helfman M. Source: The New York State Dental Journal. 2002 December; 68(10): 24-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12611313
•
Analgesia during radial artery cannulation: comparison of the effects of lidocaine applied by local injection or iontophoresis. Author(s): Sherwin J, Awad IT, Sadler PJ, Liddle AM, Rowbotham DJ. Source: Anaesthesia. 2003 May; 58(5): 474-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12751506
•
Analgesic efficacy of low doses of intravenously administered lidocaine on experimental laser-induced pain: a placebo controlled study. Author(s): Nielsen JC, Arendt-Nielsen L, Bjerring P, Carlsson P. Source: Reg Anesth. 1991 January-February; 16(1): 28-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2007102
•
Analysis of lidocaine on the COBAS INTEGRA. Author(s): Liu-Allison LY, Hui RA, Schwenzer KS. Source: Ann Clin Lab Sci. 1997 March-April; 27(2): 105-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9098509
•
Anesthetic effect of intrauterine lidocaine plus naproxen sodium in endometrial biopsy. Author(s): Dogan E, Celiloglu M, Sarihan E, Demir A. Source: Obstetrics and Gynecology. 2004 February; 103(2): 347-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14754707
•
Anesthetic efficacy of different volumes of lidocaine with epinephrine for inferior alveolar nerve blocks. Author(s): Nusstein J, Reader A, Beck FM. Source: Gen Dent. 2002 July-August; 50(4): 372-5; Quiz 376-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12640855
•
Anesthetic efficacy of intrauterine lidocaine for endometrial biopsy: a randomized double-masked trial. Author(s): Trolice MP, Fishburne C Jr, McGrady S. Source: Obstetrics and Gynecology. 2000 March; 95(3): 345-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10711541
Studies
43
•
Articaine versus lidocaine plus bupivacaine for peribulbar anaesthesia in cataract surgery. Author(s): Ozdemir M, Ozdemir G, Zencirci B, Oksuz H. Source: British Journal of Anaesthesia. 2004 February; 92(2): 231-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14722174
•
Assessment of intravenous lidocaine for the treatment of subjective tinnitus. Author(s): Otsuka K, Pulec JL, Suzuki M. Source: Ear, Nose, & Throat Journal. 2003 October; 82(10): 781-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14606175
•
Assessment of pain during venous puncture using a visual analog scale and problems associated with prolonged attachment of the lidocaine patch (PENLES). Author(s): Fujino Y, Nosaka S. Source: Anesthesia and Analgesia. 2004 January; 98(1): 274. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14693648
•
Atomized lidocaine as topical anesthesia for nasogastric tube placement: A randomized, double-blind, placebo-controlled trial. Author(s): Wolfe TR, Fosnocht DE, Linscott MS. Source: Annals of Emergency Medicine. 2000 May; 35(5): 421-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10783403
•
Bacterial contamination of propofol: the effects of temperature and lidocaine. Author(s): Aydin N, Aydin N, Gultekin B, Ozgun S, Gurel A. Source: European Journal of Anaesthesiology. 2002 June; 19(6): 455-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12094922
•
Beneficial effect of intravenous lidocaine in cutaneous chronic graft-versus-host disease secondary to donor lymphocyte infusion. Author(s): Voltarelli JC, Ahmed H, Paton EJ, Stracieri AB, Holman P, Bashey A, Coutinho M, Simoes BP, Ball ED, Carrier E. Source: Bone Marrow Transplantation. 2001 July; 28(1): 97-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11498752
•
Beneficial effect of low-dose peritonsillar injection of lidocaine-adrenaline before tonsillectomy. A placebo-controlled clinical trial. Author(s): Sorensen WT, Wagner N, Aarup AT, Bonding P. Source: Auris, Nasus, Larynx. 2003 May; 30(2): 159-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12753987
44
Lidocaine
•
Benzyl alcohol attenuates the pain of lidocaine injections and prolongs anesthesia. Author(s): Williams JM, Howe NR. Source: J Dermatol Surg Oncol. 1994 November; 20(11): 730-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7962932
•
Benzyl alcohol with epinephrine as an alternative to lidocaine with epinephrine. Author(s): Bartfield JM, May-Wheeling HE, Raccio-Robak N, Lai SY. Source: The Journal of Emergency Medicine. 2001 November; 21(4): 375-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11728763
•
Bilateral buttock and leg pain after lidocaine epidural anesthesia. Author(s): Freedman JM, Rudow MP. Source: Anesthesia and Analgesia. 1999 May; 88(5): 1188. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10320197
•
Bilateral leg pain following lidocaine spinal anaesthesia. Author(s): Pinczower GR, Chadwick HS, Woodland R, Lowmiller M. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1995 March; 42(3): 217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7743573
•
Bilateral radicular pain after epidural lidocaine. Author(s): Wong CA, Benzon H, Kim C. Source: Reg Anesth. 1996 November-December; 21(6): 600-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8956403
•
Bioadhesive film for the transdermal delivery of lidocaine: in vitro and in vivo behavior. Author(s): Padula C, Colombo G, Nicoli S, Catellani PL, Massimo G, Santi P. Source: Journal of Controlled Release : Official Journal of the Controlled Release Society. 2003 March 7; 88(2): 277-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12628334
•
Both intravenous and inhaled lidocaine attenuate reflex bronchoconstriction but at different plasma concentrations. Author(s): Groeben H, Silvanus MT, Beste M, Peters J. Source: American Journal of Respiratory and Critical Care Medicine. 1999 February; 159(2): 530-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9927369
Studies
45
•
Botulinum a toxin and detrusor sphincter dyssynergia: a double-blind lidocainecontrolled study in 13 patients with spinal cord disease. Author(s): de Seze M, Petit H, Gallien P, de Seze MP, Joseph PA, Mazaux JM, Barat M. Source: European Urology. 2002 July; 42(1): 56-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12121731
•
Breaking the cycle: lidocaine therapy for habit cough. Author(s): Sherman JM. Source: J Fla Med Assoc. 1997 June-July; 84(5): 308-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9260434
•
Breast milk lidocaine levels in tumescent liposuction. Author(s): Dryden RM, Lo MW. Source: Plastic and Reconstructive Surgery. 2000 May; 105(6): 2267-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10839430
•
Buffered lidocaine decreases the pain of digital anesthesia in the foot. Author(s): Friedman HE, Jules KT, Springer K, Jennings M. Source: Journal of the American Podiatric Medical Association. 1997 May; 87(5): 219-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9158315
•
Buffered lidocaine for skin infiltration prior to hemodialysis. Author(s): Richtsmeier AJ, Hatcher JW. Source: Journal of Pain and Symptom Management. 1995 April; 10(3): 198-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7629414
•
Buffered lidocaine: analgesia for intravenous line placement in children. Author(s): Klein EJ, Shugerman RP, Leigh-Taylor K, Schneider C, Portscheller D, Koepsell T. Source: Pediatrics. 1995 May; 95(5): 709-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7724308
•
Buffering lidocaine with sodium bicarbonate. Author(s): Doolan KL. Source: Am J Hosp Pharm. 1994 October 15; 51(20): 2564-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7847419
46
Lidocaine
•
Bupivacaine versus lidocaine for third molar surgery: a double-blind, randomized, crossover study. Author(s): Bouloux GF, Punnia-Moorthy A. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 1999 May; 57(5): 510-4; Discussion 515. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10319823
•
Cardiac arrest after interscalene brachial plexus block with ropivacaine and lidocaine. Author(s): Reinikainen M, Hedman A, Pelkonen O, Ruokonen E. Source: Acta Anaesthesiologica Scandinavica. 2003 August; 47(7): 904-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12859315
•
Cardiovascular effects of intraosseous injections of 2 percent lidocaine with 1:100,000 epinephrine and 3 percent mepivacaine. Author(s): Replogle K, Reader A, Nist R, Beck M, Weaver J, Meyers WJ. Source: The Journal of the American Dental Association. 1999 May; 130(5): 649-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10332129
•
Carpal ligament decompression under local anaesthesia: the effect of lidocaine warming and alkalinisation on infiltration pain. Author(s): Yiannakopoulos CK. Source: Journal of Hand Surgery (Edinburgh, Lothian). 2004 February; 29(1): 32-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14734067
•
Cerebral protection by lidocaine during cardiac operations. Author(s): Mitchell SJ, Pellett O, Gorman DF. Source: The Annals of Thoracic Surgery. 1999 April; 67(4): 1117-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10320260
•
Chemoembolization for hepatocellular carcinoma: effect of intraarterial lidocaine in peri- and post-procedural pain and hospitalization. Author(s): Romano M, Giojelli A, Tamburrini O, Salvatore M. Source: Radiol Med (Torino). 2003 April; 105(4): 350-5. English, Italian. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12835628
•
Children's preference of benzocaine gel versus the lidocaine patch. Author(s): Wu SJ, Julliard K. Source: Pediatr Dent. 2003 July-August; 25(4): 401-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13678108
Studies
47
•
Chromatographic determination of free lidocaine and its active metabolites in plasma from patients under epidural anesthesia. Author(s): Kakiuchi Y, Fukuda T, Miyabe M, Homma M, Toyooka H, Kohda Y. Source: Int J Clin Pharmacol Ther. 2002 November; 40(11): 493-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12698986
•
Comment: bioavailability and safety of two ceftriaxone formulations--exposure to lidocaine questioned. Author(s): Seay RE. Source: The Annals of Pharmacotherapy. 1997 April; 31(4): 501-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9101021
•
Comparative benefit of preemptively applied thiopental for propofol injection pain: the advantage over lidocaine. Author(s): Azma T, Kawai K, Tamura H, Okada K, Okida M. Source: Hiroshima J Med Sci. 2004 March; 53(1): 13-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15274426
•
Comparative, double-blind, randomized, placebo-controlled trial of intraperitoneal of bupivacaine and lidocaine for pain control after diagnostic laparoscopy. Author(s): Parsanezhad ME, Lahsaee M, Alborzi S, Vafaei H, Schmidt EH. Source: The Journal of the American Association of Gynecologic Laparoscopists. 2003 August; 10(3): 311-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14567803
•
Comparison of 1% and 2% lidocaine epidural anaesthesia combined with sevoflurane general anaesthesia utilizing a constant bispectral index. Author(s): Shono A, Sakura S, Saito Y, Doi K, Nakatani T. Source: British Journal of Anaesthesia. 2003 December; 91(6): 825-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14633753
•
Comparison of 1% ropivacaine with 0.75% bupivacaine and 2% lidocaine for peribulbar anaesthesia. Author(s): Nicholson G, Sutton B, Hall GM. Source: British Journal of Anaesthesia. 2000 January; 84(1): 89-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10740553
•
Comparison of articaine and bupivacaine/lidocaine for sub-Tenon's anaesthesia in cataract extraction. Author(s): Gouws P, Galloway P, Jacob J, English W, Allman KG. Source: British Journal of Anaesthesia. 2004 February; 92(2): 228-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14722173
48
Lidocaine
•
Comparison of clonidine and epinephrine in lidocaine for cervical plexus block. Author(s): Molnar RR, Davies MJ, Scott DA, Silbert BS, Mooney PH. Source: Reg Anesth. 1997 March-April; 22(2): 137-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9089855
•
Comparison of EMLA and lidocaine iontophoresis for cannulation analgesia. Author(s): Moppett IK, Szypula K, Yeoman PM. Source: European Journal of Anaesthesiology. 2004 March; 21(3): 210-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15055894
•
Comparison of intravenous and topical lidocaine as a suppressant of coughing after bronchoscopy during general anesthesia. Author(s): Jakobsen CJ, Ahlburg P, Holdgard HO, Olsen KH, Thomsen A. Source: Acta Anaesthesiologica Scandinavica. 1991 April; 35(3): 238-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2038931
•
Comparison of lidocaine 2% gel versus amethocaine as the sole anesthetic agent for strabismus surgery. Author(s): Yu CB, Wong VW, Fan DS, Yip WW, Lam DS. Source: Ophthalmology. 2003 July; 110(7): 1426-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12867403
•
Comparison of lidocaine and saline for epidural top-up during combined spinalepidural anesthesia in volunteers. Author(s): Trautman WJ 3rd, Liu SS, Kopacz DJ. Source: Anesthesia and Analgesia. 1997 March; 84(3): 574-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9052304
•
Cutaneous lidocaine allergy confirmed by patch testing. Author(s): Kaufmann JM, Hale EK, Ashinoff RA, Cohen DE. Source: J Drugs Dermatol. 2002 September; 1(2): 192-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12847744
•
Cytochrome P450 1A2 is a major determinant of lidocaine metabolism in vivo: effects of liver function. Author(s): Orlando R, Piccoli P, De Martin S, Padrini R, Floreani M, Palatini P. Source: Clinical Pharmacology and Therapeutics. 2004 January; 75(1): 80-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14749694
Studies
49
•
Delayed-type hypersensitivity to lidocaine. Author(s): Mackley CL, Marks JG Jr, Anderson BE. Source: Archives of Dermatology. 2003 March; 139(3): 343-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12622627
•
Depth of cutaneous analgesia after application of a eutectic mixture of the local anesthetics lidocaine and prilocaine (EMLA cream). Author(s): Wahlgren CF, Quiding H. Source: Journal of the American Academy of Dermatology. 2000 April; 42(4): 584-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10727302
•
Determination of lidocaine in hair of drug fatalities by headspace solid-phase microextraction. Author(s): Sporkert F, Pragst F. Source: Journal of Analytical Toxicology. 2000 July-August; 24(5): 316-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10926353
•
Determination of lidocaine in plasma by direct solid-phase microextraction combined with gas chromatography. Author(s): Koster EH, Wemes C, Morsink JB, de Jong GJ. Source: J Chromatogr B Biomed Sci Appl. 2000 February 28; 739(1): 175-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10744325
•
Development and validation of a reversed-phase liquid chromatographic method for the assay of lidocaine in aqueous humour samples. Author(s): Manna L, Bertocchi P, Valvo L, Bardocci A. Source: Journal of Pharmaceutical and Biomedical Analysis. 2002 August 1; 29(6): 11216. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12110398
•
Dextromethorphan reduces immediate and late postoperative analgesic requirements and improves patients' subjective scorings after epidural lidocaine and general anesthesia. Author(s): Weinbroum AA. Source: Anesthesia and Analgesia. 2002 June; 94(6): 1547-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12032024
•
Diagnosis and management of transient neurologic symptoms following subarachnoid block with single-shot isobaric 2% lidocaine. Author(s): Farid I, Youssef G, Banoub M, Gottlieb A, Tetzlaff JE. Source: Journal of Clinical Anesthesia. 2001 November; 13(7): 521-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11704452
50
Lidocaine
•
Diagnostic value of intravesical lidocaine for overactive bladder. Author(s): Yokoyama O, Komatsu K, Kodama K, Yotsuyanagi S, Niikura S, Namiki M. Source: The Journal of Urology. 2000 August; 164(2): 340-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10893580
•
Differences in cardiovascular response to airway stimulation at different sites and blockade of the responses by lidocaine. Author(s): Hamaya Y, Dohi S. Source: Anesthesiology. 2000 July; 93(1): 95-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10861151
•
Differential effects of peripheral ketamine and lidocaine on skin flux and hyperalgesia induced by intradermal capsaicin in humans. Author(s): Gottrup H, Bach FW, Jensen TS. Source: Clinical Physiology and Functional Imaging. 2004 March; 24(2): 103-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15056183
•
Differential effects of systemically administered ketamine and lidocaine on dynamic and static hyperalgesia induced by intradermal capsaicin in humans. Author(s): Gottrup H, Hansen PO, Arendt-Nielsen L, Jensen TS. Source: British Journal of Anaesthesia. 2000 February; 84(2): 155-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10743446
•
Diffusion of n-butyl-p-aminobenzoate (BAB), lidocaine and bupivacaine through the human dura-arachnoid mater in vitro. Author(s): Grouls R, Korsten E, Ackerman E, Hellebrekers L, van Zundert A, Breimer D. Source: European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences. 2000 December; 12(2): 125-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11102740
•
Diplopia after cataract surgery using 4% lidocaine in the absence of Wydase (sodium hyaluronidase) Author(s): Troll G, Borodic G. Source: Journal of Clinical Anesthesia. 1999 November; 11(7): 615-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10624651
•
Distributions of ethanol and intubation-related lidocaine in the brain of a trauma patient who was brain dead for about 5 days. Author(s): Moriya F, Hashimoto Y, Nakanishi A. Source: Legal Medicine (Tokyo, Japan). 2003 March; 5 Suppl 1: S118-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12935567
Studies
51
•
Does injection of steroids and lidocaine in the shoulder relieve bursitis? Author(s): Gutierrez G, Burroughs M. Source: The Journal of Family Practice. 2004 June; 53(6): 488-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15189724
•
Does lidocaine provoke clinically significant vasospasm? Author(s): Azma T, Okida M. Source: Acta Anaesthesiologica Scandinavica. 2003 October; 47(9): 1174-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969115
•
Does lidocaine-prilocaine cream (EMLA) decrease the pain of neonatal circumcision? Author(s): Taylor H; Family Practice Inquiries Network. Source: American Family Physician. 2004 February 15; 69(4): 909-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989579
•
Does pregnancy protect against intrathecal lidocaine-induced transient neurologic symptoms? Author(s): Aouad MT, Siddik SS, Jalbout MI, Baraka AS. Source: Anesthesia and Analgesia. 2001 February; 92(2): 401-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11159240
•
Double-blind, randomized, placebo-controlled trial to determine the efficacy of eutectic lidocaine/prilocaine (EMLA) cream for decreasing pain during local anaesthetic infiltration for out-patient haemorrhoidectomy. Author(s): Roxas MF, Talip BN, Crisostomo AC. Source: Asian J Surg. 2003 January; 26(1): 26-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12527491
•
Effect of alkalinization of lidocaine on median nerve block. Author(s): Ririe DG, Walker FO, James RL, Butterworth J. Source: British Journal of Anaesthesia. 2000 February; 84(2): 163-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10743447
•
Effect of pre- or post-traumatically applied i.v. lidocaine on primary and secondary hyperalgesia after experimental heat trauma in humans. Author(s): Holthusen H, Irsfeld S, Lipfert P. Source: Pain. 2000 December 1; 88(3): 295-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11068117
52
Lidocaine
•
Effect of retrobulbar injection of lidocaine on saccadic velocities. Author(s): Irving EL, Arshinoff SA, Samis W, Lillakas L, Lui B, Laporte JT, Steinbach MJ. Source: Journal of Cataract and Refractive Surgery. 2004 February; 30(2): 350-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15030823
•
Effectiveness of lidocaine lubricant for discomfort during pediatric urethral catheterization. Author(s): Gerard LL, Cooper CS, Duethman KS, Gordley BM, Kleiber CM. Source: The Journal of Urology. 2003 August; 170(2 Pt 1): 564-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12853831
•
Effectiveness, tolerability, and impact on quality of life of the 5% lidocaine patch in diabetic polyneuropathy. Author(s): Barbano RL, Herrmann DN, Hart-Gouleau S, Pennella-Vaughan J, Lodewick PA, Dworkin RH. Source: Archives of Neurology. 2004 June; 61(6): 914-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15210530
•
Effects of adding epinephrine plus fentanyl to low-dose lidocaine for spinal anesthesia in outpatient knee arthroscopy. Author(s): Turker G, UCkunkaya N, Yilmazlar A, Demirag B, Tokat O. Source: Acta Anaesthesiologica Scandinavica. 2003 September; 47(8): 986-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12904191
•
Effects of clonidine on lidocaine metabolism in human or rat liver microsomes. Author(s): Inomata S, Nagashima A, Osaka Y, Tanaka E, Toyooka H. Source: Journal of Anesthesia. 2003; 17(4): 281-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14625719
•
Effects of lidocaine into knee on QF strength and EMG in patients with ACL lesion. Author(s): Konishi Y, Suzuki Y, Hirose N, Fukubayashi T. Source: Medicine and Science in Sports and Exercise. 2003 November; 35(11): 1805-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14600541
•
Effects of lidocaine on cerebral oxygen supply-consumption balance and hemodynamics during anesthesia induction in patients with supratentorial tumor. Author(s): Li SY, Xu SY, Ye XP, Xu R, Yu N, Xu P, Hou JL. Source: Di Yi June Yi Da Xue Xue Bao. 2004 February; 24(2): 223-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14965835
Studies
53
•
Effects of ropivacaine on human neutrophil function: comparison with bupivacaine and lidocaine. Author(s): Mikawa K, Akamarsu H, Nishina K, Shiga M, Obara H, Niwa Y. Source: European Journal of Anaesthesiology. 2003 February; 20(2): 104-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12622492
•
Effects of topical nitroglycerin and intravenous lidocaine on propofol-induced pain on injection. Author(s): O'Hara JR Jr, Sprung J, Laseter JT, Maurer WG, Carpenter T, Beven M, Mascha E. Source: Anesthesia and Analgesia. 1997 April; 84(4): 865-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9085972
•
Efficacy of 2% lidocaine injection as a topical agent in cataract surgery. Author(s): Huang W, Liu B, Liu J, Xu J, Lin Z. Source: Yan Ke Xue Bao. 2003 September; 19(3): 153-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574970
•
Efficacy of lidocaine 2% jelly as a topical agent in cataract surgery. Author(s): Koch PS. Source: Journal of Cataract and Refractive Surgery. 1999 May; 25(5): 632-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10330635
•
Efficacy of lidocaine patch 5% in the treatment of focal peripheral neuropathic pain syndromes: a randomized, double-blind, placebo-controlled study. Author(s): Meier T, Wasner G, Faust M, Kuntzer T, Ochsner F, Hueppe M, Bogousslavsky J, Baron R. Source: Pain. 2003 November; 106(1-2): 151-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14581122
•
ELA-max: A new topical lidocaine formulation. Author(s): Goldman RD. Source: The Annals of Pharmacotherapy. 2004 May; 38(5): 892-4. Epub 2004 March 30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15054144
•
Electromotive drug administration of lidocaine to anesthetize the bladder before botulinum-A toxin injections into the detrusor. Author(s): Schurch B, Reitz A, Tenti G. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 2004 June; 42(6): 338-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15007374
54
Lidocaine
•
Empiric lidocaine: Deja vu (all over again?) Author(s): Cairns CB, Paradis NA. Source: Annals of Emergency Medicine. 2000 December; 36(6): 626-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11097706
•
Evaluation of eutectic lidocaine/prilocaine cream (EMLA) for steroid joint injection in children with juvenile rheumatoid arthritis: a double blind, randomized, placebo controlled trial. Author(s): Uziel Y, Berkovitch M, Gazarian M, Koren G, Silverman ED, Schneider R, Laxer RM. Source: The Journal of Rheumatology. 2003 March; 30(3): 594-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12610822
•
Evaluation of re-challenge in patients with suspected lidocaine allergy. Author(s): Amsler E, Flahault A, Mathelier-Fusade P, Aractingi S. Source: Dermatology (Basel, Switzerland). 2004; 208(2): 109-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15056998
•
Failure of meperidine to anesthetize human median nerve. A blinded comparison with lidocaine and saline. Author(s): Flanagan MT, Walker FO, Butterworth J. Source: Reg Anesth. 1997 January-February; 22(1): 73-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9010950
•
Fasciculations, myalgia and biochemical changes following succinylcholine with atracurium and lidocaine pretreatment. Author(s): Raman SK, San WM. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1997 May; 44(5 Pt 1): 498-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9161744
•
Fat partitioning of lidocaine in tumescent liposuction. Author(s): Hagerty T, Klein P. Source: Annals of Plastic Surgery. 1999 April; 42(4): 372-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10213396
•
Fentanyl and lidocaine versus lidocaine for Bier block. Author(s): Arthur JM, Heavner JE, Mian T, Rosenberg PH. Source: Reg Anesth. 1992 July-August; 17(4): 223-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1515390
Studies
55
•
Fentanyl prolongs lidocaine spinal anesthesia without prolonging recovery. Author(s): Liu S, Chiu AA, Carpenter RL, Mulroy MF, Allen HW, Neal JM, Pollock JE. Source: Anesthesia and Analgesia. 1995 April; 80(4): 730-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7893026
•
Fetal heart rate after epidural lidocaine and bupivacaine for elective cesarean section. Author(s): Loftus JR, Holbrook RH, Cohen SE. Source: Anesthesiology. 1991 September; 75(3): 406-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1888047
•
Fiberoptic endotracheal intubation after topicalization with in-circuit nebulized lidocaine in a child with a difficult airway. Author(s): Tsui BC, Cunningham K. Source: Anesthesia and Analgesia. 2004 May; 98(5): 1286-8, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15105202
•
Findings of study of needle-free jet-injection system with lidocaine are contrary to published reports. Author(s): Zsigmond EK. Source: Anesthesia and Analgesia. 2004 May; 98(5): 1504; Author Reply 1504-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15105247
•
Fixed drug eruption induced by lidocaine and patch testing. Author(s): Garcia JC, Torre F, Sanchez M, Martin JA, Canto G. Source: J Investig Allergol Clin Immunol. 1997 March-April; 7(2): 127-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9161940
•
Fixed drug eruption induced by lidocaine. Author(s): Kawada A, Noguchi H, Hiruma M, Tajima S, Ishibashi A, Marshall J. Source: Contact Dermatitis. 1996 December; 35(6): 375. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9118644
•
Fluvoxamine is a more potent inhibitor of lidocaine metabolism than ketoconazole and erythromycin in vitro. Author(s): Wang JS, Backman JT, Wen X, Taavitsainen P, Neuvonen PJ, Kivisto KT. Source: Pharmacology & Toxicology. 1999 November; 85(5): 201-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10608481
56
Lidocaine
•
Focus on mobilisation after lower abdominal surgery. A double-blind randomised comparison of epidural bupivacaine with morphine vs. lidocaine with morphine for postoperative analgesia. Author(s): Rygnestad T, Zahlsen K, Bergslien O, Dale O. Source: Acta Anaesthesiologica Scandinavica. 1999 April; 43(4): 380-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10225069
•
Follicular fluid Lidocaine levels during transvaginal oocyte retrieval. Author(s): Bailey-Pridham DD, Reshef E, Drury K, Cook CL, Hurst HE, Yussman MA. Source: Fertility and Sterility. 1990 January; 53(1): 171-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2295339
•
Free and total lidocaine levels in cardiac surgical patients. Author(s): Landow L, Wilson J, Heard SO, Townsend P, VanderSalm TJ, Okike ON, Pezzella TA, Pasque M. Source: J Cardiothorac Anesth. 1990 June; 4(3): 340-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1983405
•
Free lidocaine concentrations during continuous epidural anesthesia in geriatric patients. Author(s): Fukuda T, Kakiuchi Y, Miyabe M, Kihara S, Kohda Y, Toyooka H. Source: Regional Anesthesia and Pain Medicine. 2003 May-June; 28(3): 215-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12772139
•
Grand mal seizure during cardiopulmonary bypass: probable lidocaine toxicity. Author(s): Lee DL, Ayoub C, Shaw RK, Fontes ML. Source: Journal of Cardiothoracic and Vascular Anesthesia. 1999 April; 13(2): 200-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10230957
•
Growth of Escherichia coli in propofol, lidocaine, and mixtures of propofol and lidocaine. Author(s): Sakuragi T, Yanagisawa K, Shirai Y, Dan K. Source: Acta Anaesthesiologica Scandinavica. 1999 April; 43(4): 476-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10225084
•
Haemodynamic changes associated with portal triad clamping are suppressed by prior hepatic pedicle infiltration with lidocaine in humans. Author(s): Lentschener C, Franco D, Bouaziz H, Mercier FJ, Fouqueray B, Landault C, Mazoit JX, Benhamou D. Source: British Journal of Anaesthesia. 1999 May; 82(5): 691-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10536544
Studies
57
•
Heated lidocaine. Author(s): Kapur A. Source: Annals of Emergency Medicine. 1996 July; 28(1): 104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8669728
•
Hemodynamic and blockade effects of high/low epinephrine doses during axillary brachial plexus blockade with lidocaine 1.5%: A randomized, double-blinded study. Author(s): Dogru K, Duygulu F, Yildiz K, Kotanoglu MS, Madenoglu H, Boyaci A. Source: Regional Anesthesia and Pain Medicine. 2003 September-October; 28(5): 401-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14556129
•
Hepatic chemoembolization: effect of intraarterial lidocaine on pain and postprocedure recovery. Author(s): Hartnell GG, Gates J, Stuart K, Underhill J, Brophy DP. Source: Cardiovascular and Interventional Radiology. 1999 July-August; 22(4): 293-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10415218
•
Hepatic function as assessed by lidocaine metabolism in sickle cell disease. Author(s): Gremse DA, Fillingim E, Hoff CJ, Wells DJ, Boerth RC. Source: The Journal of Pediatrics. 1998 June; 132(6): 989-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9627591
•
Hepatic lidocaine metabolism and complications of cirrhosis. Implications for assessing patient priority for hepatic transplantation. Author(s): Shiffman ML, Fisher RA, Sanyal AJ, Edinboro LE, Luketic VA, Purdum PP 3rd, Raymond P, Posner MP. Source: Transplantation. 1993 April; 55(4): 830-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8475560
•
Hepatic lidocaine metabolism and liver histology in patients with chronic hepatitis and cirrhosis. Author(s): Shiffman ML, Luketic VA, Sanyal AJ, Duckworth PF, Purdum PP 3rd, Contos MJ, Mills AS, Edinboro LE, Poklis A. Source: Hepatology (Baltimore, Md.). 1994 April; 19(4): 933-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8138268
•
Hepatic lidocaine metabolism and liver histology. Author(s): Fabbri A, Bianchi GP, Marchesini G. Source: Hepatology (Baltimore, Md.). 1995 June; 21(6): 1761-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7768525
58
Lidocaine
•
Hepatic lidocaine metabolism in chronic hepatitis C virus hepatitis with or without steatosis. Author(s): Taliani G, Duca F, Lecce R, Livoli D, Pasquazzi C, De Bac C. Source: Hepatology (Baltimore, Md.). 1995 June; 21(6): 1760-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7605510
•
Hepatic lidocaine metabolism is useful in the selection of patients in need of liver transplantation. Author(s): Luketic VA, Shiffman ML, Fisher RA, Sanyal AJ, Purdum PP 3rd, Posner MP. Source: Transplantation Proceedings. 1993 February; 25(1 Pt 2): 1072-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8442046
•
Highly sensitive bioassay of lidocaine in human plasma by high-performance liquid chromatography-tandem mass spectrometry. Author(s): Bo LD, Mazzucchelli P, Marzo A. Source: J Chromatogr A. 1999 August 27; 854(1-2): 3-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10497923
•
High-performance liquid chromatography-tandem electrospray mass spectrometry for the determination of lidocaine and its metabolites in human plasma and urine. Author(s): Abdel-Rehim M, Bielenstein M, Askemark Y, Tyrefors N, Arvidsson T. Source: J Chromatogr B Biomed Sci Appl. 2000 May 12; 741(2): 175-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10872587
•
Histological comparison of donor livers and lidocaine metabolism in the utilization of organs for liver transplantation. Author(s): Rosenlof LK, Sawyer RG, Broccoli AV, Ishitani MB, Stevenson WC, Pruett TL. Source: Transplantation Proceedings. 1993 February; 25(1 Pt 2): 1662-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8442229
•
Histopathology of an adverse reaction to a eutectic mixture of the local anesthetics lidocaine and prilocaine. Author(s): Hoss DM, Gross EG, Grant-Kels JM. Source: Journal of Cutaneous Pathology. 1999 February; 26(2): 100-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10082401
•
Hospital discharge after ambulatory knee arthroscopy: A comparison of epidural 2chloroprocaine versus lidocaine. Author(s): Neal JM, Deck JJ, Kopacz DJ, Lewis MA. Source: Regional Anesthesia and Pain Medicine. 2001 January-February; 26(1): 35-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11172509
Studies
59
•
Hyaluronidase as an adjuvant in bupivacaine-lidocaine mixture for retrobulbar/peribulbar block. Author(s): Kallio H, Paloheimo M, Maunuksela EL. Source: Anesthesia and Analgesia. 2000 October; 91(4): 934-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11004052
•
Hyperbaric lidocaine spinal anesthesia: do we need an alternative? Author(s): Carpenter RL. Source: Anesthesia and Analgesia. 1995 December; 81(6): 1125-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7486092
•
Hyperosmolarity does not contribute to transient radicular irritation after spinal anesthesia with hyperbaric 5% lidocaine. Author(s): Hampl KF, Schneider MC, Thorin D, Ummenhofer W, Drewe J. Source: Reg Anesth. 1995 September-October; 20(5): 363-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8519711
•
Hypoalgesic effect of EMLA and lidocaine gel applied on human oral mucosa: quantitative evaluation by sensory and pain thresholds to argon laser stimulation. Author(s): Svensson P, Bjerring P, Arendt-Nielsen L, Kaaber S. Source: Anesthesia Progress. 1993 January-February; 39(1-2): 4-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8507024
•
Hypotension in spinal anesthesia for cesarean section: a comparison of 0.5% hyperbaric bupivacaine and 5% hyperbaric lidocaine. Author(s): Kyokong O, Charuluxananan S, Pothimamaka S, Leerapun R. Source: J Med Assoc Thai. 2001 June; 84 Suppl 1: S256-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11529341
•
Immunological modulation by lidocaine-epinephrine and prilocaine-felypressin on the functions related to natural immunity in neutrophils and macrophages. Author(s): Azuma Y, Ohura K. Source: Current Drug Targets. Immune, Endocrine and Metabolic Disorders. 2004 March; 4(1): 29-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15032623
•
Improved application of Lidocaine/Prilocaine cream in children. A randomized and prospectively controlled study of two application regimes. Author(s): Gad LN, Olsen KS, Lysgaard AB, Culmsee M. Source: Acta Anaesthesiologica Scandinavica. 2004 April; 48(4): 491-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15025614
60
Lidocaine
•
In children, nitrous oxide decreases pain on injection of propofol mixed with lidocaine. Author(s): Beh T, Splinter W, Kim J. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 December; 49(10): 1061-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477679
•
Induced endothelial cell loss in phacoemulsification using topical anesthesia plus intracameral lidocaine. Author(s): Elvira JC, Hueso JR, Martinez-Toldos J, Mengual E, Artola A. Source: Journal of Cataract and Refractive Surgery. 1999 May; 25(5): 640-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10330637
•
Inhaled albuterol, but not intravenous lidocaine, protects against intubation-induced bronchoconstriction in asthma. Author(s): Maslow AD, Regan MM, Israel E, Darvish A, Mehrez M, Boughton R, Loring SH. Source: Anesthesiology. 2000 November; 93(5): 1198-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11046206
•
Injection pain and postinjection pain of the palatal-anterior superior alveolar injection, administered with the Wand Plus system, comparing 2% lidocaine with 1:100,000 epinephrine to 3% mepivacaine. Author(s): Nusstein J, Burns Y, Reader A, Beck M, Weaver J. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2004 February; 97(2): 164-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14970775
•
Intracameral lidocaine in trabeculectomy. A preliminary safety and efficacy study. Author(s): Lai JS, Tham CC, Lam DS. Source: Indian J Ophthalmol. 2002 September; 50(3): 197-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12355693
•
Intradermal sufentanil does not improve lidocaine-induced local anesthesia. Author(s): Hartmannsgruber MW, Atanassoff PG, Budde A, Brull SJ, Kain ZN, Silverman DG. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 February; 50(2): 153-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12560306
Studies
61
•
Intraocular lidocaine in phacoemulsification: an endothelium and blood-aqueous barrier permeability study. Author(s): Iradier MT, Fernandez C, Bohorquez P, Moreno E, del Castillo JB, Garcia J. Source: Ophthalmology. 2000 May; 107(5): 896-900; Discussion 900-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10811081
•
Intraocular penetration of topical lidocaine 4%. Author(s): Bellucci R, Morselli S, Pucci V, Zordan R, Magnolfi G. Source: Journal of Cataract and Refractive Surgery. 1999 May; 25(5): 642-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10330638
•
Intraocular pressure, quality of block, and degree of pain associated with ropivacaine in peribulbar block: a comparative randomized study with bupivacaine-lidocaine mixture. Author(s): Ozcan AA, Ozdemir N, Gunes Y, Bozkurt A, Yagmur M, Alparslan ZN. Source: Eur J Ophthalmol. 2003 November-December; 13(9-10): 794-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14700102
•
Intraperitoneal lidocaine for postoperative pain after laparoscopy. Author(s): Elhakim M, Elkott M, Ali NM, Tahoun HM. Source: Acta Anaesthesiologica Scandinavica. 2000 March; 44(3): 280-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10714840
•
Intrauterine lidocaine gel application for pain relief during and after hysterosalpingography. Author(s): Kafali H, Cengiz M, Demir N. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 October; 83(1): 65-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14511875
•
Intrauterine lidocaine infusion for pain management in first-trimester abortions. Author(s): Edelman A, Nichols MD, Leclair C, Astley S, Shy K, Jensen JT. Source: Obstetrics and Gynecology. 2004 June; 103(6): 1267-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15172863
•
Intravenous lidocaine as adjuvant to sevoflurane anesthesia for endotracheal intubation in children. Author(s): Aouad MT, Sayyid SS, Zalaket MI, Baraka AS. Source: Anesthesia and Analgesia. 2003 May; 96(5): 1325-7, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12707127
62
Lidocaine
•
Intravenous lidocaine versus intravenous amiodarone (in a new aqueous formulation) for incessant ventricular tachycardia. Author(s): Somberg JC, Bailin SJ, Haffajee CI, Paladino WP, Kerin NZ, Bridges D, Timar S, Molnar J; Amio-Aqueous Investigators. Source: The American Journal of Cardiology. 2002 October 15; 90(8): 853-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12372573
•
Intravenous lignocaine (lidocaine) infusion for the treatment of chronic daily headache with substantial medication overuse. Author(s): Williams DR, Stark RJ. Source: Cephalalgia : an International Journal of Headache. 2003 December; 23(10): 96371. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14984229
•
Intravesical lidocaine for formalin-induced suprapubic pain: case report. Author(s): Mishra S, Singhal AK, Kannan TR, Bhatnagar S. Source: Am J Hosp Palliat Care. 2004 January-February; 21(1): 58-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14748525
•
Iontophoretic administration of 2% lidocaine HCl and 1:100,000 epinephrine in humans. Author(s): Ashburn MA, Gauthier M, Love G, Basta S, Gaylord B, Kessler K. Source: The Clinical Journal of Pain. 1997 March; 13(1): 22-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9084949
•
Is the analgesic effect of systemic lidocaine mediated through opioid receptors? Author(s): Cohen SP, Mao J. Source: Acta Anaesthesiologica Scandinavica. 2003 August; 47(7): 910-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12859317
•
Jetting lidocaine through the atomizer. Author(s): Garewal DS, Sharma A, Smith T. Source: Anesthesiology. 1999 February; 90(2): 634. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9952178
•
Lidocaine alters activation gating of cardiac Na channels. Author(s): Hanck DA, Makielski JC, Sheets MF. Source: Pflugers Archiv : European Journal of Physiology. 2000 April; 439(6): 814-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10784357
Studies
63
•
Lidocaine attenuates monocyte chemoattractant protein-1 production and chemotaxis in human monocytes: possible mechanisms for its effect on inflammation. Author(s): Li CY, Tsai CS, Hsu PC, Chueh SH, Wong CS, Ho ST. Source: Anesthesia and Analgesia. 2003 November; 97(5): 1312-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14570645
•
Lidocaine dosing duality in liposuction: "safe" only when highly diluted. Author(s): de Jong RH. Source: Plastic and Reconstructive Surgery. 2004 April 15; 113(5): 1513-4; Author Reply 1514-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15060376
•
Lidocaine enhances Galphai protein function. Author(s): Benkwitz C, Garrison JC, Linden J, Durieux ME, Hollmann MW. Source: Anesthesiology. 2003 November; 99(5): 1093-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14576545
•
Lidocaine for the relief of incapacitating tinnitus. Author(s): Marzo S, Stankiewicz JA, Consiglio AP. Source: Ear, Nose, & Throat Journal. 2004 April; 83(4): 236-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15147093
•
Lidocaine gel versus drops. Author(s): Gaynes BI. Source: Ophthalmology. 2003 December; 110(12): 2429-30; Author Reeply 2430. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14644734
•
Lidocaine hydrochloride. Author(s): Mackley CL, Marks JG Jr. Source: American Journal of Contact Dermatitis : Official Journal of the American Contact Dermatitis Society. 2003 December; 14(4): 221-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14738727
•
Lidocaine induces a slow inactivated state in rat skeletal muscle sodium channels. Author(s): Chen Z, Ong BH, Kambouris NG, Marban E, Tomaselli GF, Balser JR. Source: The Journal of Physiology. 2000 April 1; 524 Pt 1: 37-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10747182
64
Lidocaine
•
Lidocaine inhibits tyrosine kinase activity of the epidermal growth factor receptor and suppresses proliferation of corneal epithelial cells. Author(s): Hirata M, Sakaguchi M, Mochida C, Sotozono C, Kageyama K, Kuroda Y, Hirose M. Source: Anesthesiology. 2004 May; 100(5): 1206-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15114219
•
Lidocaine intradermal injection--a new approach in tinnitus therapy: preliminary report. Author(s): Savastano M. Source: Adv Ther. 2004 January-February; 21(1): 13-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15191153
•
Lidocaine or fentanyl applied to the surgical wound during spinal surgery produces potent postoperative analgesia. Author(s): Takano Y, Takano M, Kuno Y, Sato E, Sato I. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 AugustSeptember; 50(7): 751-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12944456
•
Lidocaine patch 5% improves pain, stiffness, and physical function in osteoarthritis pain patients. A prospective, multicenter, open-label effectiveness trial. Author(s): Burch F, Codding C, Patel N, Sheldon E. Source: Osteoarthritis and Cartilage / Oars, Osteoarthritis Research Society. 2004 March; 12(3): 253-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14972343
•
Lidocaine patch 5% with systemic analgesics such as gabapentin: a rational polypharmacy approach for the treatment of chronic pain. Author(s): White WT, Patel N, Drass M, Nalamachu S. Source: Pain Medicine (Malden, Mass.). 2003 December; 4(4): 321-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14750908
•
Lidocaine patch 5%. Author(s): Pasero C. Source: The American Journal of Nursing. 2003 September; 103(9): 75, 77-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14501479
•
Lidocaine spray used to capture a live Clinostomum parasite causing human laryngitis. Author(s): Kitagawa N, Oda M, Totoki T, Washizaki S, Oda M, Kifune T. Source: American Journal of Otolaryngology. 2003 September-October; 24(5): 341-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13130449
Studies
65
•
Lidocaine/prilocaine cream (EMLA) has an antibacterial effect in vitro. Author(s): Kerenyi M, Batai R, Juhasz V, Batai I. Source: The Journal of Hospital Infection. 2004 January; 56(1): 75-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14706277
•
Lidocaine: the optimal timing of intravenous administration in attenuation of increase of intraocular pressure during tracheal intubation. Author(s): Wang YM, Chung KC, Lu HF, Huang YW, Lin KC, Yang LC, Lin CR. Source: Acta Anaesthesiol Sin. 2003 June; 41(2): 71-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12934420
•
Lidocaine-assisted xylocaine jelly anesthesia versus one quadrant sub-Tenon infiltration for self-sealing sclerocorneal incision routine phacoemulsification. Author(s): Sekundo W, Dick HB, Schmidt JC. Source: Eur J Ophthalmol. 2004 March-April; 14(2): 111-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15134107
•
Lidocaine-prilocaine cream for analgesia during circumcision in newborn boys. Author(s): Taddio A, Ohlsson K, Ohlsson A. Source: Cochrane Database Syst Rev. 2000; (2): Cd000496. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10796371
•
Lumbar segmental nerve blocks with local anesthetics, pain relief, and motor function: a prospective double-blind study between lidocaine and ropivacaine. Author(s): Wolff AP, Wilder Smith OH, Crul BJ, van de Heijden MP, Groen GJ. Source: Anesthesia and Analgesia. 2004 August; 99(2): 496-501, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15271730
•
Management of pain from heel lance with lidocaine-prilocaine (EMLA) cream: is it safe and efficacious in preterm infants? Author(s): Stevens B, Johnston C, Taddio A, Jack A, Narciso J, Stremler R, Koren G, Aranda J. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1999 August; 20(4): 216-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10475595
•
Maternal and neonatal effects of single-dose epidural anesthesia with lidocaine and morphine for cesarean delivery. Author(s): Niruthisard S, Somboonviboon W, Thaithumyanon P, Mahutchawaroj N, Chaiyakul A. Source: J Med Assoc Thai. 1998 February; 81(2): 103-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9529839
66
Lidocaine
•
Mechanically induced axon reflex and hyperalgesia in human UV-B burn are reduced by systemic lidocaine. Author(s): Koppert W, Brueckl V, Weidner C, Schmelz M. Source: European Journal of Pain (London, England). 2004 June; 8(3): 237-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15109974
•
Mechanism of lidocaine block of late current in long Q-T mutant Na+ channels. Author(s): Dumaine R, Kirsch GE. Source: The American Journal of Physiology. 1998 February; 274(2 Pt 2): H477-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9486250
•
Mega-dose lidocaine dangers seen in "tumescent" liposuction. Author(s): de Jong RH. Source: Journal of Clinical Monitoring and Computing. 2000 January; 16(1): 77-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12578098
•
Methemoglobinemia after axillary block with bupivacaine and additional injection of lidocaine in the operative field. Author(s): Schroeder TH, Dieterich HJ, Muhlbauer B. Source: Acta Anaesthesiologica Scandinavica. 1999 April; 43(4): 480-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10225085
•
Methemoglobinemia after topical anesthesia with lidocaine and benzocaine for a difficult intubation. Author(s): Kern K, Langevin PB, Dunn BM. Source: Journal of Clinical Anesthesia. 2000 March; 12(2): 167-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10818334
•
Methemoglobinemia associated with a prilocaine-lidocaine cream. Author(s): Kumar AR, Dunn N, Naqvi M. Source: Clinical Pediatrics. 1997 April; 36(4): 239-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9114997
•
Methemoglobinemia complicating topical lidocaine used during endoscopic procedures. Author(s): Karim A, Ahmed S, Siddiqui R, Mattana J. Source: The American Journal of Medicine. 2001 August; 111(2): 150-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11498069
Studies
67
•
Minidose lidocaine-fentanyl spinal anesthesia in ambulatory surgery: prophylactic nalbuphine versus nalbuphine plus droperidol. Author(s): Ben-David B, DeMeo PJ, Lucyk C, Solosko D. Source: Anesthesia and Analgesia. 2002 December; 95(6): 1596-600, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12456423
•
Minimum effective anaesthetic concentration of hyperbaric lidocaine for spinal anaesthesia. Author(s): Peng PW, Chan VW, Perlas A. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1998 February; 45(2): 122-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9512845
•
Mixing of propofol and lidocaine. Author(s): Wild G, Shinde S, Newton M. Source: British Journal of Anaesthesia. 1999 July; 83(1): 193-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10616345
•
Molecular action of lidocaine on the voltage sensors of sodium channels. Author(s): Sheets MF, Hanck DA. Source: The Journal of General Physiology. 2003 February; 121(2): 163-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12566542
•
Monitoring a randomized clinical trial for futility: the north-Norwegian lidocaine intervention trial. Author(s): Berntsen RF, Rasmussen K, Bjornstad JF. Source: Statistics in Medicine. 1991 March; 10(3): 405-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2028124
•
More on lidocaine use in cocaine toxicity. Author(s): Derlet RW. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 1998 August; 24(4): 303. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9814229
•
MR Arthrography: a proposal for solution optimization with lidocaine. An in vitro experience. Author(s): Genovese E, Callegari L, Magenta Biasina A, Angeretti MG, Sosto P, Faletti C, Fugazzola C. Source: Radiol Med (Torino). 2003 November-December; 106(5-6): 489-96. English, Italian. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14735015
68
Lidocaine
•
Multicenter randomized trial and a systematic overview of lidocaine in acute myocardial infarction. Author(s): Sadowski ZP, Alexander JH, Skrabucha B, Dyduszynski A, Kuch J, Nartowicz E, Swiatecka G, Kong DF, Granger CB. Source: American Heart Journal. 1999 May; 137(5): 792-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10220626
•
Muscle afferent block by intramuscular injection of lidocaine for the treatment of writer's cramp. Author(s): Kaji R, Kohara N, Katayama M, Kubori T, Mezaki T, Shibasaki H, Kimura J. Source: Muscle & Nerve. 1995 February; 18(2): 234-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7823984
•
Nebulization of lidocaine with varied oxygen flow rates. Author(s): Tsui BCh, Malherbe S. Source: Anesthesia and Analgesia. 2003 July; 97(1): 302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12819000
•
Nebulized lidocaine administered to infants and children undergoing flexible bronchoscopy. Author(s): Gjonaj ST, Lowenthal DB, Dozor AJ. Source: Chest. 1997 December; 112(6): 1665-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9404766
•
Nebulized lidocaine as an adjunct to endotracheal intubation in the prehospital setting. Author(s): Kenny JF, Molloy K, Pollack M, Ortiz MT. Source: Prehospital Disaster Med. 1996 October-December; 11(4): 312-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10163615
•
Nebulized lidocaine in the treatment of refractory tussive syncope. Author(s): Whims LA, Zappasodi SJ, Morley TF. Source: J Am Osteopath Assoc. 1998 March; 98(3): 170-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9558835
•
Nebulized lidocaine in the treatment of severe asthma in children: a pilot study. Author(s): Decco ML, Neeno TA, Hunt LW, O'Connell EJ, Yunginger JW, Sachs MI. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 1999 January; 82(1): 29-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9988203
Studies
69
•
Nebulized or sprayed lidocaine as anesthesia for nasogastric intubations. Author(s): Spektor M, Kaplan J, Kelley J, Wheary J, Dalsey W. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 2000 April; 7(4): 406-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10805633
•
Neonatal mydriasis: intravenous lidocaine adverse reaction. Author(s): Berger I, Steinberg A, Schlesinger Y, Seelenfreund M, Schimmel MS. Source: Journal of Child Neurology. 2002 May; 17(5): 400-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12150593
•
Nerve root inflammation demonstrated by magnetic resonance imaging in a patient with transient neurologic symptoms after intrathecal injection of lidocaine. Author(s): Avidan A, Gomori M, Davidson E. Source: Anesthesiology. 2002 July; 97(1): 257-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12131127
•
Neurobehavioral differences in superselective Wada testing with amobarbital versus lidocaine. Author(s): Fitzsimmons BF, Marshall RS, Pile-Spellman J, Lazar RM. Source: Ajnr. American Journal of Neuroradiology. 2003 August; 24(7): 1456-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12917146
•
Neuropathic pain can be relieved by drugs that are use-dependent sodium channel blockers: lidocaine, carbamazepine, and mexiletine. Author(s): Tanelian DL, Brose WG. Source: Anesthesiology. 1991 May; 74(5): 949-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1850581
•
Neurotoxicity of lidocaine: implications for spinal anesthesia and neuroprotection. Author(s): Johnson ME. Source: Journal of Neurosurgical Anesthesiology. 2004 January; 16(1): 80-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14676575
•
New analgesics for neuropathic pain: the lidocaine patch. Author(s): Argoff CE. Source: The Clinical Journal of Pain. 2000 June; 16(2 Suppl): S62-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10870742
70
Lidocaine
•
Nitrous oxide enhances the level of sensory block produced by intrathecal lidocaine. Author(s): Fassoulaki A, Sarantopoulos C, Zotou M. Source: Anesthesia and Analgesia. 1997 November; 85(5): 1108-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9356109
•
Nitrous oxide vs periprostatic nerve block with 1% lidocaine during transrectal ultrasound guided biopsy of the prostate: a prospective, randomized, controlled trial. Author(s): Manikandan R, Srirangam SJ, Brown SC, O'Reilly PH, Collins GN. Source: The Journal of Urology. 2003 November; 170(5): 1881-3; Discussion 1883. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14532798
•
No anesthetic or analgesic benefit of neostigmine 1 mg added to intravenous regional anesthesia with lidocaine 0.5% for hand surgery. Author(s): McCartney CJ, Brill S, Rawson R, Sanandaji K, Iagounova A, Chan VW. Source: Regional Anesthesia and Pain Medicine. 2003 September-October; 28(5): 414-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14556131
•
No significant analgesic benefit of adding lidocaine 2% to aciclovir 5% cream as treatment of episodes of herpes labialis. Author(s): Bodsworth NJ, Bayerl C, Cunningham A, Silny W. Source: Herpes : the Journal of the Ihmf. 2003 August; 10(2): 53-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14577955
•
No support for intravenous lidocaine airway reflex suppression during rapid sequence intubation. Author(s): Zemenick RB. Source: Annals of Emergency Medicine. 1995 November; 26(5): 660. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7486384
•
Non-alkalinized and alkalinized 2-chloroprocaine vs lidocaine for intravenous regional anesthesia during outpatient hand surgery. Author(s): Lavin PA, Henderson CL, Vaghadia H. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1999 October; 46(10): 939-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10522580
•
Normal shoulder proprioception and the effect of lidocaine injection. Author(s): Zuckerman JD, Gallagher MA, Lehman C, Kraushaar BS, Choueka J. Source: Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons. [et Al.]. 1999 January-February; 8(1): 11-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10077789
Studies
71
•
On the molecular nature of the lidocaine receptor of cardiac Na+ channels. Modification of block by alterations in the alpha-subunit III-IV interdomain. Author(s): Bennett PB, Valenzuela C, Chen LQ, Kallen RG. Source: Circulation Research. 1995 September; 77(3): 584-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7641328
•
Onset and duration of hypoalgesia following application of lidocaine spray on genital mucosa. Author(s): van der Burght M, Schonemann NK, Laursen JK, Arendt-Nielsen L, Bjerring P. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1994 November; 73(10): 809-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7817734
•
Onset and duration of hypoalgesia of lidocaine spray applied to oral mucosa--a dose response study. Author(s): Schonemann NK, van der Burght M, Arendt-Nielsen L, Bjerring P. Source: Acta Anaesthesiologica Scandinavica. 1992 October; 36(7): 733-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1441878
•
Onset, intensity of blockade and somatosensory evoked potential changes of the lumbosacral dermatomes after epidural anesthesia with alkalinized lidocaine. Author(s): Benzon HT, Toleikis JR, Dixit P, Goodman I, Hill JA. Source: Anesthesia and Analgesia. 1993 February; 76(2): 328-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8424510
•
Operative risk by the lidocaine test (MEGX) in resected patients for HCC on cirrhosis. Author(s): Ravaioli M, Grazi GL, Principe A, Ercolani G, Cescon M, Gardini A, Varotti G, Del Gaudio M, Cavallari A. Source: Hepatogastroenterology. 2003 September-October; 50(53): 1552-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14571784
•
Optimum usage of prilocaine-lidocaine cream in premature ejaculation. Author(s): Atikeler MK, Gecit I, Senol FA. Source: Andrologia. 2002 December; 34(6): 356-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12472618
•
Oral clonidine prolongs lidocaine spinal anesthesia in human volunteers. Author(s): Liu S, Chiu AA, Neal JM, Carpenter RL, Bainton BG, Gerancher JC. Source: Anesthesiology. 1995 June; 82(6): 1353-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7793648
72
Lidocaine
•
Oral mucosal blood flow, plasma epinephrine and haemodynamic responses after injection of lidocaine with epinephrine during midazolam sedation and isoflurane anaesthesia. Author(s): Homma Y, Ichinohe T, Kaneko Y. Source: British Journal of Anaesthesia. 1999 April; 82(4): 570-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10472225
•
Oral or intravenous lidocaine administration to perform megx test? Author(s): Giannini E, Botta F, Romagnoli P, Testa R. Source: Digestive Diseases and Sciences. 2000 May; 45(5): 1011-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10795769
•
Oral sucrose compares favourably with lidocaine-prilocaine cream for pain relief during venepuncture in neonates. Author(s): Abad F, Diaz-Gomez NM, Domenech E, Gonzalez D, Robayna M, Feria M. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 February; 90(2): 160-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11236045
•
Organ preserving effect of lidocaine administration in the model of orthotopic liver transplantation from non-heart-beating donors. Author(s): Kusano T, Shiraishi M, Miyaguni T, Hara J, Muto Y. Source: Transplantation Proceedings. 1996 June; 28(3): 1928-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8658950
•
Overnight 5% lidocaine ointment for treatment of vulvar vestibulitis. Author(s): Zolnoun DA, Hartmann KE, Steege JF. Source: Obstetrics and Gynecology. 2003 July; 102(1): 84-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12850611
•
Patient-controlled lidocaine analgesia for acromioplasty surgery. Author(s): Mallon WJ, Thomas CW. Source: Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons. [et Al.]. 2000 March-April; 9(2): 85-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10810685
•
Percutaneous lidocaine administration via a new iontophoresis system in children: tolerability and absence of systemic bioavailability. Author(s): Kearns GL, Heacook J, Daly SJ, Singh H, Alander SW, Qu S. Source: Pediatrics. 2003 September; 112(3 Pt 1): 578-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12949287
Studies
73
•
Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. Author(s): Koppert W, Weigand M, Neumann F, Sittl R, Schuettler J, Schmelz M, Hering W. Source: Anesthesia and Analgesia. 2004 April; 98(4): 1050-5, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15041597
•
Plasma levels of lidocaine, o-toluidine, and prilocaine after application of 8.5 g Oraqix in patients with generalized periodontitis: effect on blood methemoglobin and tolerability. Author(s): Herdevall BM, Klinge B, Persson L, Huledal G, Abdel-Rehim M. Source: Acta Odontologica Scandinavica. 2003 August; 61(4): 230-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14582591
•
Postoperative sore throat: effect of lidocaine jelly and pomade on endotracheal intubation. Author(s): Basaranoglu G, Erden V, Delatioglu H. Source: Journal of Clinical Anesthesia. 2004 February; 16(1): 79-80; Author Reply 80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14984868
•
Potentiation of spermicidal activity of 2',4'-dichlorobenzamil by lidocaine. Author(s): Moudgil P, Gupta A, Sharma A, Gupta S, Tiwary AK. Source: Indian J Exp Biol. 2002 December; 40(12): 1373-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12974399
•
Prilocaine versus plain or buffered lidocaine for local anesthesia in laceration repair: randomized double-blind comparison. Author(s): Karcioglu O, Topacoglu H, Ayrik C, Ozucelik DN, Soysa S. Source: Croatian Medical Journal. 2003 December; 44(6): 716-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14652885
•
Prolonged spinal anesthesia in a parturient after administration of a standard epidural test dose with lidocaine and epinephrine. Author(s): Kuczkowski KM. Source: Acta Anaesthesiologica Scandinavica. 2003 September; 47(8): 1050. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12904203
•
Propofol inhibits lidocaine metabolism in human and rat liver microsomes. Author(s): Inomata S, Nagashima A, Osaka Y, Kazama T, Tanaka E, Sato S, Toyooka H. Source: Journal of Anesthesia. 2003; 17(4): 246-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14625712
74
Lidocaine
•
Pupil dilatation with intracameral 1% lidocaine during glaucoma filtering surgery. Author(s): Sodhi PK, Verma L, Ratan SK. Source: American Journal of Ophthalmology. 2004 April; 137(4): 783-4; Author Reply 784-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15059737
•
Quantification of three lidocaine metabolites and their conjugates. Author(s): Tam YK, Ke J, Coutts RT, Wyse DG, Gray MR. Source: Pharmaceutical Research. 1990 May; 7(5): 504-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2367319
•
Quantitative and selective assessment of sensory block during lumbar epidural anaesthesia with 1% or 2% lidocaine. Author(s): Sakura S, Sumi M, Yamada Y, Saito Y, Kosaka Y. Source: British Journal of Anaesthesia. 1998 November; 81(5): 718-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10193282
•
Quantitative and selective evaluation of differential sensory nerve block after transdermal lidocaine. Author(s): Sakai T, Tomiyasu S, Yamada H, Ono T, Sumikawa K. Source: Anesthesia and Analgesia. 2004 January; 98(1): 248-51, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14693629
•
Quantitative assessment of differential sensory blockade after lumbar epidural lidocaine. Author(s): Tay B, Wallace MS, Irving G. Source: Anesthesia and Analgesia. 1997 May; 84(5): 1071-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9141933
•
Quantitative assessment of differential sensory nerve block after lidocaine spinal anesthesia. Author(s): Liu S, Kopacz DJ, Carpenter RL. Source: Anesthesiology. 1995 January; 82(1): 60-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7832336
•
Quantitative sensory examination in human epidural anaesthesia and analgesia: effects of lidocaine. Author(s): Brennum J, Arendt-Nielsen L, Secher NH, Jensen TS, Bjerring P. Source: Pain. 1992 October; 51(1): 27-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1454401
Studies
75
•
Radial artery cannulation: topical amethocaine gel versus lidocaine infiltration. Author(s): Olday SJ, Walpole R, Wang JY. Source: British Journal of Anaesthesia. 2002 April; 88(4): 580-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12066736
•
Randomized trial of buffered versus plain lidocaine for local anaesthesia in open carpal tunnel decompression. Author(s): Watts AC, Gaston P, Hooper G. Source: Journal of Hand Surgery (Edinburgh, Lothian). 2004 February; 29(1): 30-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14734066
•
Randomized trial of lidocaine ointment versus placebo for the treatment of postpartum perineal pain. Author(s): Minassian VA, Jazayeri A, Prien SD, Timmons RL, Stumbo K. Source: Obstetrics and Gynecology. 2002 December; 100(6): 1239-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12468168
•
Randomized trial of lidocaine vs lidocaine/bupivacaine periprostatic injection on longitudinal pain scores after prostate biopsy. Author(s): Lee-Elliott CE, Dundas D, Patel U. Source: The Journal of Urology. 2004 January; 171(1): 247-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14665886
•
Randomized, placebo-controlled treatment of anal fissure by lidocaine, EMLA, and GTN in children. Author(s): Sonmez K, Demirogullari B, Ekingen G, Turkyilmaz Z, Karabulut R, Basaklar AC, Kale N. Source: Journal of Pediatric Surgery. 2002 September; 37(9): 1313-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12194122
•
Reduction of myocardial infarct size in rabbits and inhibition of activation of rabbit and human neutrophils by lidocaine. Author(s): Vitola JV, Forman MB, Holsinger JP, Atkinson JB, Murray JJ. Source: American Heart Journal. 1997 March; 133(3): 315-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9060800
•
Registered nurses' choices regarding the use of intradermal lidocaine for intravenous insertions: the challenge of changing practice. Author(s): Brown J. Source: Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses. 2002 June; 3(2): 71-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12050838
76
Lidocaine
•
Review of lidocaine patch 5% studies in the treatment of postherpetic neuralgia. Author(s): Davies PS, Galer BS. Source: Drugs. 2004; 64(9): 937-47. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15101784
•
Rocuronium combined with i.v. lidocaine for rapid tracheal intubation. Author(s): Yorukoglu D, Asik Y, Okten F. Source: Acta Anaesthesiologica Scandinavica. 2003 May; 47(5): 583-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12699517
•
Ropivacaine compared to lidocaine for tonsillectomy under local anaesthesia. Author(s): Apostolopoulos K, Labropoulou E, Samaan R, Bogris K. Source: Eur Arch Otorhinolaryngol. 2003 August;260(7):355-7. Epub 2003 March 12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12937909
•
Safe usage of lidocaine for liposuction. Author(s): Breunig J. Source: Plastic Surgical Nursing : Official Journal of the American Society of Plastic and Reconstructive Surgical Nurses. 2003 Fall; 23(3): 130-1. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14666809
•
Safety of lidocaine-prilocaine cream application four times a day in premature neonates: a pilot study. Author(s): Essink-Tebbes CM, Wuis EW, Liem KD, van Dongen RT, Hekster YA. Source: European Journal of Pediatrics. 1999 May; 158(5): 421-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10333129
•
Seizures after a bier block with clonidine and lidocaine. Author(s): Ahmed SU, Vallejo R, Hord ED. Source: Anesthesia and Analgesia. 2004 August; 99(2): 593-4, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15271746
•
Serum lidocaine concentrations in asthmatics undergoing research bronchoscopy. Author(s): Langmack EL, Martin RJ, Pak J, Kraft M. Source: Chest. 2000 April; 117(4): 1055-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10767239
•
Sevoflurane requirements to suppress responses to transcutaneous electrical stimulation during epidural anesthesia with 0.5% and 1% lidocaine. Author(s): Shono A, Saito Y, Sakura S, Doi K, Yokokawa N. Source: Anesthesia and Analgesia. 2003 October; 97(4): 1168-72, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14500176
Studies
77
•
Should intrathecal lidocaine be used in the 21st century? Author(s): Gaiser RR. Source: Journal of Clinical Anesthesia. 2000 September; 12(6): 476-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11090735
•
Simultaneous determination of lidocaine and bupivacaine in human plasma: application to pharmacokinetics. Author(s): Lotfi H, Debord J, Dreyfuss MF, Marquet P, Ben Rhaiem M, Feiss P, Lachatre G. Source: Therapeutic Drug Monitoring. 1997 April; 19(2): 160-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9108643
•
Spinal 2-chloroprocaine: a comparison with lidocaine in volunteers. Author(s): Kouri ME, Kopacz DJ. Source: Anesthesia and Analgesia. 2004 January; 98(1): 75-80, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14693590
•
Study on the efficacy of ELA-Max (4% liposomal lidocaine) compared with EMLA cream (eutectic mixture of local anesthetics) using thermosensory threshold analysis in adult volunteers. Author(s): Tang MB, Goon AT, Goh CL. Source: The Journal of Dermatological Treatment. 2004 April; 15(2): 84-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15204157
•
Systemic anaphylaxis following local lidocaine administration during a dental procedure. Author(s): Chiu CY, Lin TY, Hsia SH, Lai SH, Wong KS. Source: Pediatric Emergency Care. 2004 March; 20(3): 178-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15094577
•
The binding of acetaminophen, lidocaine, and valproic acid to human milk. Author(s): Bailey DN, Briggs JR. Source: American Journal of Clinical Pathology. 2004 May; 121(5): 754-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15151216
•
The effect of lidocaine sprayed on the major duodenal papilla on the frequency of post-ERCP pancreatitis. Author(s): Schwartz JJ, Lew RJ, Ahmad NA, Shah JN, Ginsberg GG, Kochman ML, Brensinger CM, Long WB. Source: Gastrointestinal Endoscopy. 2004 February; 59(2): 179-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14745389
78
Lidocaine
•
The efficacy of 5% lidocaine-prilocaine (EMLA) cream on pain during intravenous injection of propofol. Author(s): McCluskey A, Currer BA, Sayeed I. Source: Anesthesia and Analgesia. 2003 September; 97(3): 713-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12933391
•
The long-term effect of repeated intravenous lidocaine on central pain and possible correlation in positron emission tomography measurements. Author(s): Cahana A, Carota A, Montadon ML, Annoni JM. Source: Anesthesia and Analgesia. 2004 June; 98(6): 1581-4, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15155309
•
The use of intrauterine lidocaine to minimize pain during hysterosalpingography: a randomized trial. Author(s): Frishman GN, Spencer PK, Weitzen S, Plosker S, Shafi F. Source: Obstetrics and Gynecology. 2004 June; 103(6): 1261-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15172862
•
Topical lidocaine-prilocaine spray for the treatment of premature ejaculation: a proof of concept study. Author(s): Henry R, Morales A. Source: International Journal of Impotence Research : Official Journal of the International Society for Impotence Research. 2003 August; 15(4): 277-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12934056
•
Transrectal periprostatic lidocaine injection anesthesia for transrectal prostate biopsy: a prospective study. Author(s): Ozveri H, Cevik I, Dillioglugil O, Akdas A. Source: Prostate Cancer and Prostatic Diseases. 2003; 6(4): 311-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14663473
•
Treatment of asthma with nebulized lidocaine: a randomized, placebo-controlled study. Author(s): Hunt LW, Frigas E, Butterfield JH, Kita H, Blomgren J, Dunnette SL, Offord KP, Gleich GJ. Source: The Journal of Allergy and Clinical Immunology. 2004 May; 113(5): 853-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15131566
•
Treatment of cochlear tinnitus with transtympanic infusion of 4% lidocaine into the tympanic cavity. Author(s): Sakata H, Kojima Y, Koyama S, Furuya N, Sakata E. Source: Int Tinnitus J. 2001; 7(1): 46-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14964956
Studies
79
•
Upper airway reactivity and upper respiratory tract infection: effect of nebulized lidocaine. Author(s): Hall AP, Fox AJ, Raphael JH, Nandwani N, Smith G. Source: British Journal of Anaesthesia. 1999 June; 82(6): 857-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10562779
•
Urinary bladder scanning after day-case arthroscopy under spinal anaesthesia: comparison between lidocaine, ropivacaine, and levobupivacaine. Author(s): Breebaart MB, Vercauteren MP, Hoffmann VL, Adriaensen HA. Source: British Journal of Anaesthesia. 2003 March; 90(3): 309-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12594142
•
Use of a dental roll coated with flavored viscous lidocaine for nasal mucosal surgery. Author(s): Bogle MA, Joseph AK, MacFarlane D. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2004 May; 30(5): 792-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15099327
•
Use of lidocaine spray for pain relief and improved quality of life in terminally ill cancer patients. Author(s): Joglekar DM, Joshi MY, Paranjape SY, Sowani AS. Source: J Assoc Physicians India. 2002 November; 50: 1458-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12583494
•
Use of lidocaine-prilocaine patch to decrease intramuscular injection pain does not adversely affect the antibody response to diphtheria-tetanus-acellular pertussisinactivated poliovirus-Haemophilus influenzae type b conjugate and hepatitis B vaccines in infants from birth to six months of age. Author(s): Halperin BA, Halperin SA, McGrath P, Smith B, Houston T. Source: The Pediatric Infectious Disease Journal. 2002 May; 21(5): 399-405. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12150176
•
Use of the lidocaine gel container for urethral dilation and intravesical drug delivery. Author(s): Zimmern PE. Source: Urology. 1997 April; 49(4): 618-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9111637
•
Use of topical lidocaine in the treatment of muscle tension dysphonia. Author(s): Dworkin JP, Meleca RJ, Simpson ML, Garfield I. Source: Journal of Voice : Official Journal of the Voice Foundation. 2000 December; 14(4): 567-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11130113
80
Lidocaine
•
Usefulness of self-administration of intramuscular lidocaine in the prehospital setting for ventricular tachyarrhythmias unassociated with acute myocardial infarction (the "Shahal" experience in Israel). Author(s): Roth A, Malov N, Bloch Y, Schlesinger Z, Laniado S, Kaplinski E. Source: The American Journal of Cardiology. 1997 March 1; 79(5): 611-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9068518
•
Using lidocaine for peripheral i.v. insertions: patients' preferences and pain experiences. Author(s): Brown J. Source: Medsurg Nursing : Official Journal of the Academy of Medical-Surgical Nurses. 2003 April; 12(2): 95-100; Quiz 101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12736928
•
Utility of a simplified lidocaine and potassium infusion in diagnosing long QT syndrome among patients with borderline QTc interval prolongation. Author(s): Chauhan VS, Krahn AD, Klein GJ, Skanes AC, Yee R. Source: Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc. 2004 January; 9(1): 12-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14731211
•
V. A new route, jet injection of lidocaine for skin wheal for painless intravenous catheterization. Author(s): Zsigmond EK, Darby P, Koenig HM, Goll E. Source: Int J Clin Pharmacol Ther. 1999 February; 37(2): 90-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10082173
•
Venous levels of lidocaine and bupivacaine after midtarsal ankle block. Author(s): Mineo R, Sharrock NE. Source: Reg Anesth. 1992 January-February; 17(1): 47-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1599895
•
Venous response after lidocaine administration in arm veins. Author(s): Watanabe R, Yui N, Nishioka A, Inagaki M, Kotoura H, Watabe R. Source: Japanese Circulation Journal. 1998 August; 62(8): 576-80. Erratum In: Jpn Circ J 1998 September; 62(9): 713. Watabe R[corrected to Watanabe R]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9741734
Studies
81
•
Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine. Author(s): Moore JH Jr, Kolaczynski JW, Morales LM, Considine RV, Pietrzkowski Z, Noto PF, Caro JF. Source: Aesthetic Plastic Surgery. 1995 July-August; 19(4): 335-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7484471
•
Virginia Mason Medical Center's promotion of outpatient lidocaine spinal anesthesia questioned. Author(s): Lambert DH. Source: Anesthesia and Analgesia. 2003 April; 96(4): 1237; Author Reply 1237-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12651701
•
Volume-sensitive basolateral K+ channels in HT-29/B6 cells: block by lidocaine, quinidine, NPPB, and Ba2+. Author(s): Illek B, Fischer H, Kreusel KM, Hegel U, Clauss W. Source: The American Journal of Physiology. 1992 September; 263(3 Pt 1): C674-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1415516
•
Vulvar application of lidocaine for pain relief in spontaneous vaginal delivery. Author(s): Collins MK, Porter KB, Brook E, Johnson L, Williams M, Jevitt CM. Source: Obstetrics and Gynecology. 1994 September; 84(3): 335-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8058226
•
Walking with labor epidural analgesia: the impact of bupivacaine concentration and a lidocaine-epinephrine test dose. Author(s): Cohen SE, Yeh JY, Riley ET, Vogel TM. Source: Anesthesiology. 2000 February; 92(2): 387-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10691224
•
Warm steaming enhances the topical anesthetic effect of lidocaine. Author(s): Arai YC, Ueda W. Source: Anesthesia and Analgesia. 2004 April; 98(4): 982-5, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15041584
•
What constitutes an effective but safe initial dose of lidocaine to test a thoracic epidural catheter? Author(s): Holman SJ, Bosco RR, Kao TC, Mazzilli MA, Dietrich KJ, Rolain RA, Stevens RA. Source: Anesthesia and Analgesia. 2001 September; 93(3): 749-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11524351
82
Lidocaine
•
What is the best topical anesthetic for nasogastric insertion? A comparison of lidocaine gel, lidocaine spray, and atomized cocaine. Author(s): Ducharme J, Matheson K. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2003 October; 29(5): 427-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14583715
•
Which drug prevents tachycardia and hypertension associated with tracheal intubation: lidocaine, fentanyl, or esmolol? Author(s): Helfman SM, Gold MI, DeLisser EA, Herrington CA. Source: Anesthesia and Analgesia. 1991 April; 72(4): 482-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1672488
•
Which lidocaine dose should be used for the MEGX liver function test? Author(s): Reichel C, Wienkoop G, Nacke A, Sudhop T, Spengler U, Sauerbruch T. Source: Journal of Hepatology. 1995 May; 22(5): 600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7650345
•
Wound infiltration with lidocaine prolongs postoperative analgesia after haemorrhoidectomy with spinal anaesthesia. Author(s): Morisaki H, Masuda J, Fukushima K, Iwao Y, Suzuki K, Matsushima M. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1996 September; 43(9): 914-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8874908
•
Xylocain (lidocaine, lignocaine), its discovery and Gordh's contribution to its clinical use. Author(s): Holmdahl MH. Source: Acta Anaesthesiologica Scandinavica. Supplementum. 1998; 113: 8-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9932112
83
CHAPTER 2. NUTRITION AND LIDOCAINE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and lidocaine.
Finding Nutrition Studies on Lidocaine The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “lidocaine” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
84
Lidocaine
The following information is typical of that found when using the “Full IBIDS Database” to search for “lidocaine” (or a synonym): •
Allergic response to metabisulfite in lidocaine anesthetic solution. Author(s): Department of Pediatric Dentistry, Virginia Commonwealth University, Richmond 23298-0566, USA. Source: Campbell, J R Maestrello, C L Campbell, R L Anesth-Prog. 2001 Winter; 48(1): 21-6 0003-3006
•
Baricity and the distribution of lidocaine in a spinal canal model. Author(s): Department of Anaesthesia, Ottawa Civic Hospital, Ontario, Canada. Source: Lui, A C Munhall, R J Winnie, A P Selander, D Can-J-Anaesth. 1991 May; 38(4 Pt 1): 522-6 0832-610X
•
Combined lidocaine 1% and hydroxypropyl methylcellulose 2.25% as a single anesthetic/ viscoelastic agent in phacoemulsification. Author(s): Department of Ophthalmology, Cairo University, Cairo, Egypt.
[email protected] Source: Hosny, Mohamed Eldin, Sherif Gamal Hosny, Hisham J-Cataract-Refract-Surg. 2002 May; 28(5): 834-6 0886-3350
•
Comparative toxicity of glucose and lidocaine administered intrathecally in the rat. Author(s): Department of Anesthesia, University of California, San Francisco, USA. Source: Hashimoto, K Sakura, S Bollen, A W Ciriales, R Drasner, K Reg-Anesth-PainMed. 1998 Sep-October; 23(5): 444-50 1098-7339
•
Comparison of oxymetazoline and lidocaine versus cocaine for outpatient dacryocystorhinostomy. Author(s): Department of Ophthalmology, Lions Eye Institute, Albany Medical Center, New York 12208, USA. Source: Meyer, D R Ophthal-Plast-Reconstr-Surg. 2000 May; 16(3): 201-5 0740-9303
•
Development of polymer film dosage forms of lidocaine for buccal administration. I. Penetration rate and release rate. Author(s): Faculty of Pharmacy, Meijo University, 150 Yagotoyama Tempaku-ku, 4688503, Nagoya, Japan Source: Okamoto, H Taguchi, H Iida, K Danjo, K J-Control-Release. 2001 December 13; 77(3): 253-60 0168-3659
•
Drug-induced vasodilation: in vitro and in vivo study on the effects of lidocaine and papaverine on rabbit carotid artery. Author(s): Department of Plastic Surgery, M.D. Anderson Cancer Center, Houston, TX 77030, USA. Source: Gherardini, G Gurlek, A Cromeens, D Joly, G A Wang, B G Evans, G R Microsurgery. 1998; 18(2): 90-6 0738-1085
•
Hippocampic and cerebellar concentrations of GABA following withdrawal of valproate and lidocaine kindling. Source: Balaita, C Hategan, D Manole, E Voiculescu, V Ulmeanu, A Neurol-Psychiatr(Bucur). 1988 Jan-March; 26(1): 23-9 0377-502X
•
Pre-incision infiltration with lidocaine reduces pain and opioid consumption after reduction mammoplasty. Author(s): Department of Anaesthesia, Ottawa Civic Hospital, University of Ottawa, Ontario, Canada. Source: Rosaeg, O P Bell, M Cicutti, N J Dennehy, K C Lui, A C Krepski, B Reg-AnesthPain-Med. 1998 Nov-December; 23(6): 575-9 1098-7339
Nutrition
85
•
Preparation and evaluation of double-phased mucoadhesive suppositories of lidocaine utilizing Carbopol and white beeswax. Author(s): Department of Clinical Pharmacy, Hoshi University, Ebara 2-4-41, Shinagawa-ku, Tokyo, Japan. Source: Yahagi, R Onishi, H Machida, Y J-Control-Release. 1999 August 27; 61(1-2): 1-8 0168-3659
•
Spinal anaesthesia with lidocaine 2% for caesarean section. Author(s): Department of Anaesthesiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Source: KuMarch, A Bala, I Bhukal, I Singh, H Can-J-Anaesth. 1992 November; 39(9): 915-9 0832-610X
•
The pharmacokinetics of morphine and lidocaine in critically ill patients. Author(s): Department of Anesthesiology and Intensive Care, Sheba Medical Center, Tel Hashomer, Israel.
[email protected] Source: Berkenstadt, H Segal, E Mayan, H Almog, S Rotenberg, M Perel, A Ezra, D Intensive-Care-Med. 1999 January; 25(1): 110-2 0342-4642
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
•
The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
•
The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
•
The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
•
The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
•
Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
•
Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
•
Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
86
Lidocaine
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
•
Google: http://directory.google.com/Top/Health/Nutrition/
•
Healthnotes: http://www.healthnotes.com/
•
Open Directory Project: http://dmoz.org/Health/Nutrition/
•
Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
•
WebMDHealth: http://my.webmd.com/nutrition
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to lidocaine; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Food and Diet Tendinitis Source: Healthnotes, Inc.; www.healthnotes.com
87
CHAPTER 3. ALTERNATIVE MEDICINE AND LIDOCAINE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to lidocaine. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to lidocaine and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “lidocaine” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to lidocaine: •
“Axoplasmic transport”--the catering and communication system within nerve cells. Author(s): Dahlstrom A. Source: Anesthesiology. 1974 December; 41(6): 537-41. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4139908
•
A randomized controlled trial of the efficacy of transcutaneous electrical nerve stimulation (TENS) versus lidocaine in the relief of episiotomy pain. Author(s): Lorenzana FD. Source: Philipp J Obstet Gynecol. 1999 October-December; 23(4): 135-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12179668
•
Absorption of intubation-related lidocaine from the trachea during prolonged cardiopulmonary resuscitation. Author(s): Moriya F, Hashimoto Y.
88
Lidocaine
Source: J Forensic Sci. 1998 May; 43(3): 718-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9608714 •
Antiarrhythmic actions of lidocaine. Author(s): Harrison DC, Collinsworth KA. Source: Annual Review of Medicine. 1974; 25: 143-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4596228
•
Back pain following epidural anesthesia with 2-chloroprocaine (EDTA-free) or lidocaine. Author(s): Drolet P, Veillette Y. Source: Reg Anesth. 1997 July-August; 22(4): 303-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9223193
•
Behavioral effects of prenatal exposure to lidocaine in the rat: effects of dosage and of gestational age at administration. Author(s): Smith RF, Kurkjian MF, Mattran KM, Kurtz SL. Source: Neurotoxicology and Teratology. 1989 July-August; 11(4): 395-403. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2796896
•
Brain imaging of the effects of lidocaine on tinnitus. Author(s): Reyes SA, Salvi RJ, Burkard RF, Coad ML, Wack DS, Galantowicz PJ, Lockwood AH. Source: Hearing Research. 2002 September; 171(1-2): 43-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12204348
•
Brain-stem auditory-evoked potentials during lidocaine infusion in humans. Author(s): Ruth RA, Gal TJ, DiFazio CA, Moscicki JC. Source: Arch Otolaryngol. 1985 December; 111(12): 799-802. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4062651
•
Cardiac resuscitation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine, and ropivacaine in anesthetized dogs. Author(s): Groban L, Deal DD, Vernon JC, James RL, Butterworth J. Source: Anesthesia and Analgesia. 2001 January; 92(1): 37-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11133597
•
Case series: IV regional anesthesia with ketorolac and lidocaine: is it effective for the management of complex regional pain syndrome 1 in children and adolescents? Author(s): Suresh S, Wheeler M, Patel A.
Alternative Medicine 89
Source: Anesthesia and Analgesia. 2003 March; 96(3): 694-5, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12598246 •
Cerebral arterial gas embolism by helium: an unusual case successfully treated with hyperbaric oxygen and lidocaine. Author(s): Mitchell SJ, Benson M, Vadlamudi L, Miller P. Source: Annals of Emergency Medicine. 2000 March; 35(3): 300-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10692202
•
Changes in effective and lethal doses of intravenous anesthetics and lidocaine when used in combination in mice. Author(s): Barak M, Ben-Shlomo I, Katz Y. Source: J Basic Clin Physiol Pharmacol. 2001; 12(4): 315-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11868907
•
Comparative myocardial depressant effects of lidocaine, ajmalin, propranolol and quinidine. Author(s): Tomoda H, Chuck L, Parmley WW. Source: Japanese Circulation Journal. 1972 May; 36(5): 433-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5068725
•
Determining the state of the deceased during cardiopulmonary resuscitation from tissue distribution patterns of intubation-related lidocaine. Author(s): Moriya F, Hashimoto Y. Source: J Forensic Sci. 2000 July; 45(4): 846-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10914582
•
Dissociable effects of lidocaine inactivation of the rostral and caudal basolateral amygdala on the maintenance and reinstatement of cocaine-seeking behavior in rats. Author(s): Kantak KM, Black Y, Valencia E, Green-Jordan K, Eichenbaum HB. Source: The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 2002 February 1; 22(3): 1126-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11826141
•
Effect of lidocaine injection of EOAE in patients with tinnitus. Author(s): Haginomori S, Makimoto K, Araki M, Kawakami M, Takahashi H. Source: Acta Oto-Laryngologica. 1995 July; 115(4): 488-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7572122
•
Effects of epidural lidocaine anesthesia on bulls during electroejaculation. Author(s): Falk AJ, Waldner CL, Cotter BS, Gudmundson J, Barth AD.
90
Lidocaine
Source: Can Vet J. 2001 February; 42(2): 116-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11272454 •
Effects of intramuscular administration of lidocaine or bupivacaine on induction and maintenance doses of propofol evaluated by bispectral index. Author(s): Senturk M, Pembeci K, Menda F, Ozkan T, Gucyetmez B, Tugrul M, Camci E, Akpir K. Source: British Journal of Anaesthesia. 2002 December; 89(6): 849-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12453928
•
Effects of intratympanically delivered lidocaine on the auditory system in humans. Author(s): Laurikainen EA, Johansson RK, Kileny PR. Source: Ear and Hearing. 1996 February; 17(1): 49-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8741967
•
Effects of lidocaine on isolated, blood-perfused ventricular contractility in the dog. Author(s): Tsuboi M, Chiba S. Source: Heart and Vessels. 1999; 14(6): 289-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10901484
•
Effects of taurine supplementation in parenteral nutrition-associated hepatosteatosis and lidocaine metabolism. A study using isolated rat liver perfusion. Author(s): Zaman N, Tam YK, Jewell LD, Coutts RT. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 1996 May; 24(5): 534-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8723733
•
Enhancement of lidocaine-induced epidural anesthesia by deoxyaconitine in the rabbit. Author(s): Komoda Y, Nosaka S, Takenoshita M. Source: Journal of Anesthesia. 2003; 17(4): 241-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14625711
•
Inhibitory connections between AVCN and DCN: evidence from lidocaine injection in AVCN. Author(s): Shofner WP, Young ED. Source: Hearing Research. 1987; 29(1): 45-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3654396
•
Intramuscular administration of lidocaine or bupivacaine alters the effect of midazolam from sedation to hypnosis in a dose-dependent manner. Author(s): Ben-Shlomo I, Tverskoy M, Fleyshman G, Melnicko V, Katz Y.
Alternative Medicine 91
Source: J Basic Clin Physiol Pharmacol. 2003; 14(3): 257-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14964737 •
Levobupivacaine 0.125% and lidocaine 0.5% for intravenous regional anesthesia in volunteers. Author(s): Atanassoff PG, Aouad R, Hartmannsgruber MW, Halaszynski T. Source: Anesthesiology. 2002 August; 97(2): 325-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12151920
•
Lidocaine injection of auricular points in the treatment of insomnia. Author(s): Lee TN. Source: The American Journal of Chinese Medicine. 1977 Spring; 5(1): 71-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=848457
•
Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Author(s): Hong CZ. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 1994 July-August; 73(4): 256-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8043247
•
Lidocaine levels during CPR: differences after peripheral venous, central venous, and intracardiac injections. Author(s): Barsan WG, Levy RC, Weir H. Source: Annals of Emergency Medicine. 1981 February; 10(2): 73-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7224254
•
Lidocaine potentiation of bleomycin A2 cytotoxicity and DNA strand breakage in L1210 and human A-253 cells. Author(s): Lazo JS, Braun ID, Meandzija B, Kennedy KA, Pham ET, Smaldone LF. Source: Cancer Research. 1985 May; 45(5): 2103-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2580616
•
Management of tinnitus aurium with lidocaine and carbamazepine. Author(s): Shea JJ, Harell M. Source: The Laryngoscope. 1978 September; 88(9 Pt 1): 1477-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=682804
•
Modulation of the Ca2+, Mg2(+)-ATPase activity of synaptosomal plasma membrane by the local anesthetics dibucaine and lidocaine. Author(s): Garcia-Martin E, Gutierrez-Merino C.
92
Lidocaine
Source: Journal of Neurochemistry. 1990 April; 54(4): 1238-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2138212 •
Motor power pharmacodynamics of subarachnoid hyperbaric 5% lidocaine in the sitting position. Author(s): Rushmer J, Miles W, Jones RD, Ho JY, Cheung CK, Chan SS. Source: Acta Anaesthesiologica Scandinavica. 1997 May; 41(5): 557-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9181155
•
Myofascial pain response to topical lidocaine patch therapy: case report. Author(s): Dalpiaz AS, Dodds TA. Source: Journal of Pain & Palliative Care Pharmacotherapy. 2002; 16(1): 99-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14650453
•
Neuroselective sensory electrodiagnostic evaluation of 4% liposomal topical lidocaine. Author(s): Finkel JC, Yang CI, Yarvitz JL, Patel KM. Source: Anesthesia and Analgesia. 2002 May; 94(5): 1259-62, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11973201
•
Percutaneous absorption of disopyramide, lidocaine and trimecaine. Author(s): Priborsky J, Kikuchi K, Takayama K, Nagai T. Source: Acta Univ Palacki Olomuc Fac Med. 1998; 141: 31-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9684478
•
Reducing pain during hair transplant lidocaine infiltration. Author(s): Nussbaum BP. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2002 February; 28(2): 198. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11860440
•
Regional cerebral blood flow during tinnitus: a PET case study with lidocaine and auditory stimulation. Author(s): Andersson G, Lyttkens L, Hirvela C, Furmark T, Tillfors M, Fredrikson M. Source: Acta Oto-Laryngologica. 2000 October; 120(8): 967-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11200593
•
Retrobulbar anesthesia for cataract surgery: comparison of bupivacaine and bupivacaine/lidocaine combinations. Author(s): Vettese T, Breslin CW.
Alternative Medicine 93
Source: Can J Ophthalmol. 1985 June; 20(4): 131-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4052861 •
Temporary latency shifts in auditory evoked potentials by injection of lidocaine in the rat. Author(s): Murofushi T, Kaga K, Asakage T. Source: Hearing Research. 1994 June 1; 76(1-2): 53-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7928714
•
The effect of lidocaine on bacterial growth in propofol. Author(s): Vidovich MI, Peterson LR, Wong HY. Source: Anesthesia and Analgesia. 1999 April; 88(4): 936-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10195552
•
The effects of hemodilution, pH, and protamine on lidocaine plasma protein binding and red blood-cell uptake in vitro. Author(s): Remmel RP, Copa AK, Angaran DM. Source: Pharmaceutical Research. 1991 January; 8(1): 127-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1901648
•
The effects of lidocaine on hyperoxic seizure activity in the rat. Author(s): Hanna MK, Blackburn JG, Ogilvie RW, Campbell SL. Source: Experimental Neurology. 1978 February; 58(3): 562-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=620710
•
The superiority of water-diluted 0.25% to neat 1% lidocaine for trigger-point injections in myofascial pain syndrome: a prospective, randomized, double-blinded trial. Author(s): Iwama H, Akama Y. Source: Anesthesia and Analgesia. 2000 August; 91(2): 408-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10910858
•
Tissue distribution of lidocaine in critical care patients after intubation. Author(s): Moriya F, Hashimoto Y. Source: Forensic Science International. 2003 November 26; 137(2-3): 183-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14609655
•
Treatment of experimental cerebral air embolism with lidocaine and hyperbaric oxygen. Author(s): McDermott JJ, Dutka AJ, Evans DE, Flynn ET.
94
Lidocaine
Source: Undersea Biomed Res. 1990 November; 17(6): 525-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2288043 •
Treatment of tinnitus by intratympanic instillation of lignocaine (lidocaine) 2 per cent through ventilation tubes. Author(s): Podoshin L, Fradis M, David YB. Source: The Journal of Laryngology and Otology. 1992 July; 106(7): 603-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1527456
•
Value of thin-layer chromatography in two fatal cases of intoxication due to lidocaine and mepivacaine. Author(s): SUNSHINE I, FIKE WW. Source: The New England Journal of Medicine. 1964 September 3; 271: 487-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14172459
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
•
AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
•
Chinese Medicine: http://www.newcenturynutrition.com/
•
drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
•
Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
•
Google: http://directory.google.com/Top/Health/Alternative/
•
Healthnotes: http://www.healthnotes.com/
•
MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
•
Open Directory Project: http://dmoz.org/Health/Alternative/
•
HealthGate: http://www.tnp.com/
•
WebMDHealth: http://my.webmd.com/drugs_and_herbs
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
Alternative Medicine 95
The following is a specific Web list relating to lidocaine; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Bursitis Source: Healthnotes, Inc.; www.healthnotes.com Fibromyalgia Source: Integrative Medicine Communications; www.drkoop.com Heart Attack Source: Healthnotes, Inc.; www.healthnotes.com Migraine Headache Source: Integrative Medicine Communications; www.drkoop.com Sexual Dysfunction Source: Integrative Medicine Communications; www.drkoop.com Tendinitis Source: Integrative Medicine Communications; www.drkoop.com
•
Herbs and Supplements Astragalus Mem Alternative names: Huang-Qi; Astragalus membranaceus Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Glycyrrhiza Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Melaleuca Alternative names: Tea Tree Oil; Melaleuca alternifolia Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
97
CHAPTER 4. DISSERTATIONS ON LIDOCAINE Overview In this chapter, we will give you a bibliography on recent dissertations relating to lidocaine. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “lidocaine” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on lidocaine, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Lidocaine ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to lidocaine. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
Effects of lidocaine and calcium ion on the rabbit atrium by Betancourt, Oswaldo J, PhD from the University of Manitoba (Canada), 1979 http://wwwlib.umi.com/dissertations/fullcit/NK40003
•
Enhanced release of lidocaine from supersaturated solutions of lidocaine in a pressure sensitive adhesive by Cui, Yong, PhD from the Ohio State University, 2003, 212 pages http://wwwlib.umi.com/dissertations/fullcit/3124055
•
Polymeric drug delivery systems: Lidocaine microspheres for prolonged and localized in vivo anesthetic effects and light-induced drug release from polymeric device mediated by bacteriorhodopsin by Chen, Pen-Chung, PhD from University of Michigan, 2004, 93 pages http://wwwlib.umi.com/dissertations/fullcit/3121902
98
•
Lidocaine
Tuberomammillary nucleus lidocaine injections are not rewarding in the conditioned place preference paradigm but are anxiolytic in the elevated plus maze by Paquette, Jay J., MA from Queen's University at Kingston (Canada), 2003, 65 pages http://wwwlib.umi.com/dissertations/fullcit/MQ74920
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
99
CHAPTER 5. PATENTS ON LIDOCAINE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “lidocaine” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on lidocaine, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Lidocaine By performing a patent search focusing on lidocaine, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We
8Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
100
Lidocaine
will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on lidocaine: •
Anaesthetic bone cement Inventor(s): Bond; David M. (Kingston, CA), Rudan; John F. (Kingston, CA) Assignee(s): Queen's University at Kingston (Kingston, CA) Patent Number: 6,355,705 Date filed: April 1, 1997 Abstract: A polymethacrylate or other bone cement composition having analgesic properties is described. Bone cements containing up to 5% by weight of a local anaesthetic agent, such as lidocaine, have been demonstrated to elute sufficient lidocaine to provide an analgesic effect in vivo. Excerpt(s): This invention relates to surgical bone cement compositions and more particularly to bone cement compositions having anaesthetic properties, and to methods for producing local analgesia. Polymer based surgical bone cements have been used for many years to fill voids in bones and to improve fixation of implanted orthopaedic prosthetic devices. Typically such cements contain polymers or copolymers of alkyl methacrylate and/or copolymers of methyl methacrylate with methyl acrylate or styrene. The liquid compound consisting of esters of acrylic or methacrylic acid (typically methyl methacrylate) is packaged in an ampoule, possibly with additives such as premature polymerization preventers such as hydroquinone, and curing promoters such as N,N-dimethyl-p-toluidine. A polymerization initiator, typically an organic peroxy compound such as powdered benzoyl peroxide, is combined with the polymeric component and radiopacifier (such as barium sulphate or zirconium dioxide). The polymeric materials are generally sterilized by either irradiation or gas sterilization. In use, typically a bone is cut and prepared to receive a surgical implant and then the liquid and dry components of the cement, contained in the ampoule and a powder bag are mixed together to form a paste which can then be applied by the surgeon to the cut bone. The implant can then be set in the paste which, when fully polymerized, forms a continuous solid interface between the implant and the bone. It is also known to incorporate therapeutic or diagnostic substances into the bone cement for various purposes. For example, U.S. Pat. No. 4,900,546, issued Feb. 13, 1990 to Poseyn Dowty et al, teaches the incorporation of antibiotics such as gentamycin, penicillin and tetracycline; anti-cancer drugs; anti-inflammatory drugs; immuno-stimulants; immunosuppressants; osteogenic promoters and diagnostic substances such as radioactive tracers. While anti-inflammatory drugs may be defined as analgesics, such compounds are not anaesthetic agents. Web site: http://www.delphion.com/details?pn=US06355705__
•
Antipruritic composition Inventor(s): Swinehart; James M. (15 Sunset Dr., Englewood, CO 80110) Assignee(s): none reported Patent Number: 5,961,997 Date filed: March 24, 1998
Patents 101
Abstract: Antipruritic compositions comprising menthol, camphor and phenol in a carrier. The compositions preferably further comprise lidocaine and pramoxine and more preferably further comprise lidocaine, pramoxine and hydrocortisone acetate. The compositions are oil-free, lanolin-free, fragrance-free, free of formaldehyde-releasing preservatives, hypoallergenic, noncomedogenic, and nonacnegenic. They relieve itching in patients suffering from a variety of dermatoses or pruritis. The carrier contains only ingredients rated 0 or 1 with respect to comedogenicity and irritancy. Excerpt(s): The invention relates to antipruritic compositions comprising menthol, camphor and phenol in a carrier. The compositions may further comprise lidocaine and pramoxine. The compositions are hypoallergenic, noncomedogenic, nonacnegenic, oilfree, fragrance-free, lanolin-free, and free from formaldehyde-releasing preservatives. The carrier contains only ingredients rated 0 or 1 with respect to comedogenicity and irritancy. Cosmetics have been in use since Biblical times. They serve not only to soothe the skin and provide relief from minor irritations, but also to cover skin defects and to enhance beauty. The physician's credo to "first, do no harm", however, is of considerable importance concerning skin care products. If aesthetic concerns were the only consideration with respect to cosmetics, another cosmetic line would certainly not be necessary. Web site: http://www.delphion.com/details?pn=US05961997__ •
Bioadhesive polyethylene glycol ointment for medicaments Inventor(s): Gerding; Thomas G. (Georgetown, TX), Repka; Michael A. (Pleasanton, TX) Assignee(s): Mikkur, Inc. (Pleasanton, TX) Patent Number: 5,714,165 Date filed: April 1, 1992 Abstract: A therapeutic composition having wet adherent properties and particularly useful for delivery of medicaments to mucosal surfaces comprises a therapeutically effective amount of a medicament dispersed in a base material comprising from about 3 to 15% by weight of a water soluble salt of a copolymer of methyl vinyl ether and maleic acid or anhydride and from about 85 to 97% by weight of polyethylene glycol. Formulations of the base material with triamcinolone acetonide and lidocaine are particularly efficacious in the treatment of recurrent aphthous ulcers. Excerpt(s): The present invention relates to therapeutic compositions, and more particularly to bioadhesive compositions having wet adherent properties which are suitable for delivery of medicaments to mucosal surfaces and are particularly useful in the treatment of recurrent aphthous ulcers. Recurrent aphthous ulcers (RAU) or oral canker sores are the most common oral lesions afflicting humans. Studies have shown such ulcers affect 18% to 50% of the general population. As the name suggests, RAU lesions tend to recur in susceptible patients, often lasting for weeks. These lesions can be characterized as necrotizing ulcerations of oral mucosal tissue which are located on soft, non-keratinized mucosa. The lesions are painful, affect nutritional intake, and disrupt oral hygiene. They lead commonly to secondary infections by opportunistic organisms and sometimes result in scarring. The etiology of RAU has been linked to several causative factors including allergies, trauma, stress, autoimmune dysfunction, nutritional deficiencies, microbial infection, hormonal changes, and systemic disease. However, several studies have shown that whatever the specific etiology in a particular patient, the clinical manifestations of RAU are due to an altered immune response.
102
Lidocaine
Immunosuppressive steroids such as triamcinolone acetonide have been found to be effective in the treatment of RAU. A problem with steroidal therapy for RAU however, is that administration in large doses or over extended periods can cause adrenal suppression and atrophy. The dosage necessary for steroidal therapy to have therapeutic effect for RAU can be lessened, thereby decreasing the opportunity and magnitude of harmful side effects, if the therapy is applied topically rather than systemically. Furthermore, treatment periods necessary to achieve the desired therapeutic effect can be shortened if the form of the product encourages patient compliance in applying the medication on a prescribed schedule. Web site: http://www.delphion.com/details?pn=US05714165__ •
Composition for local anesthesia Inventor(s): Haraguchi; Mitsuhiro (Tokyo, JP), Ono; Kazuhiro (Tokyo, JP), Osada; Takashi (Tokyo, JP), Suzuki; Yukio (Tokyo, JP) Assignee(s): Showa Yakuhin Kako Co., Ltd. (Tokyo, JP) Patent Number: 6,008,256 Date filed: February 27, 1998 Abstract: A composition for local anesthesia which comprises (A) lidocaine, (B) a catecholamine such as epinephrine in an amount of, for example, 1/200,000 (g/ml) based on the volume of the composition, and (C) one or more amino acids such as glycine, glutamic acid, and L-glutamic acid-L-lysine or one or more hydroxycarboxylic acids such as lactic acid, glycolic acid, and citric acid, which has a duration suitable for short-time dental operations such as tooth extraction and excellent storage stability. Excerpt(s): The present invention relates to a composition for local anesthesia. More specifically, the present invention relates to a pharmaceutical composition for local anesthesia which has a duration of local anesthetic action suitable for minor dental operations such as tooth extraction and excellent storage stability. For operations in the fields of oral surgery and dental treatment, in particular, for tooth extraction and other in dental treatment, anesthetics for local injection (agents for local anesthesia) containing lidocaine (2-diethylamino-N-(2,6-dimethyl-phenyl)acetamide) as an active ingredient have been used. For example, "Xylocaine.RTM. Cartridge for Dental Use" (Fujisawa Pharmaceutical Co., Ltd.) is clinically used. This agent for local anesthesia is a composition for topical administration which contains 20 mg of lidocaine hydrochloride and 0.0125 mg of epinephrine per 1 ml of parenteral solution. The agent is usually used in an amount of 0.3-1.8 ml to carry out infiltration anesthesia or block anesthesia (see, a package insert of the drug). Agents for local anesthesia are generally formulated with a catecholamine such as epinephrine which has angiotonic effect on local capillary blood vessels to reduce blood flow. The effect of the catecholamine is to decrease bleeding in a filed of operation by lowering blood flow, and to reduce transmigration (diffusion) of an anesthetic agent being an active ingredient into blood and maintain high concentration of the anesthetic agent in the local tissue to achieve a prolonged local anesthetic effect (Collins, V. J., Principles of Anesthesiology, 2nd Ed., Lea and Febiger, Philadelphia, 1976; as a review about agents for dental local anesthesia, see, Dental Outlook, special edition, "Medical practice of tooth extraction," 4. Dental local anesthetics, pp.84-94, 1979). Web site: http://www.delphion.com/details?pn=US06008256__
Patents 103
•
Composition set and kit for use in intraocular surgery Inventor(s): Nielsen; Per Julius (Mirabellevej 12, DK-8240 Risskov, DK) Assignee(s): none reported Patent Number: 6,627,620 Date filed: June 29, 2001 Abstract: A new composition set and a kit for use by intraocular operations, preferably cataract operations. The composition set comprises a first and a second viscoelastic agent, e.g. sodium hyaluronate, containing an anaesthetic, e.g. lidocaine hydrochloride. Hereby a simplified operation and anaesthesia is achieved while at the same time the risk of complications and discomfort on the patient are reduced. Excerpt(s): The present invention relates to a composition set and a kit for use in intraocular surgery, preferably in cataract operations. The present invention has appeared in connection with intraocular operations, especially operations for cataract. In the following the problems will primarily be described in connection with such surgical interventions, however it will be within the scope of the invention to indicate composition set and kit which may be used in connection with other kinds of intraocular operations. Web site: http://www.delphion.com/details?pn=US06627620__
•
Compositions comprising lidocaine and emu oil and methods of use thereof Inventor(s): Rivlin; Daniel (4000 Towerside Ter. #2303, Miami, FL 33138) Assignee(s): none reported Patent Number: 5,698,227 Date filed: July 23, 1996 Abstract: The present invention provides compositions comprising lidocaine and emu oil. The compositions are useful in a method of anesthetizing cornified skin comprising topically administering the subject compositions. The present compositions and methods permit rapid and effective anesthesia of cornified skin, such that various surgeries and interventions can be performed without the need for subcutaneous injections of local anesthetics. The present invention further provides a compartmentalized kit having a first container providing emu oil and a second container providing an aqueous solution of lidocaine. Excerpt(s): Various anesthetics, including lidocaine, are effective as topical anesthetics for mucuous membranes and as very superficial anesthetics for the skin. Injections are generally required for anesthesia of cornified skin. The present invention provides a topical anesthetic preparation that rapidly penetrates the large stratum corneum, and thus allows effective topical anesthesia for cornified skin. The present compositions contain lidocaine and emu oil. Lidocaine is a widely used local anesthetic administered by injection or topical administration. Available preparations for topical administration include creams, ointments, jellies, solutions and aerosols. Direct topical application is used for anesthesia of mucous membranes of the nose, mouth, throat, tracheobronchial tree, esophagus and genitourinary tract. Anesthesia following topical administration is completely superficial and does not extend to submucosal structures. Topical anesthetics intended for use on cornified skin suffer from significant deficiencies. In particular, preparations of lidocaine intended for use on normal skin generally provide
104
Lidocaine
only very superficial anesthesia and/or require very long application. For example, EMLA.RTM. cream, an emulsion of lidocaine and prilocaine, is reportedly indicated as a topical anesthetic for use on normal intact skin, but requires application for at least one hour to acheve anesthesia suitable for minor dermal procedures. Accordingly, local anesthesia of cornified skin generally requires painful and inconvenient subcutaneous injections. Web site: http://www.delphion.com/details?pn=US05698227__ •
Denatonium capsaicinate and methods of producing the same Inventor(s): Blum; Melvin (Wantagh, NY), Roitberg; Michael (Highland Park, NJ) Assignee(s): Burlington Bio-Medical & Scientific Corp. (Farmingdale, NY) Patent Number: 5,891,919 Date filed: September 19, 1997 Abstract: A new compound, Denatonium Capsaicinate, and a method of producing the same are disclosed. Denatonium Capsaicinate provides an enhanced bitter and/or spicy, pungent flavor and may be used as an aversive agent, biocide, antifoulant and flavorant, for example. It is formed by reaction of a denatonium compound, Lidocaine or Lidocaine derivative with Capsaicin or a derivative thereof. Excerpt(s): This invention relates to a compound, methods of producing the compound, and means of using the compound as an aversive agent. In particular, this invention relates to the novel compound Denatonium Capsaicinate. Capsaicin provides a hot, spicy, pungent flavor as well as a numbing, burning or tingling effect when applied orally or topically. Capsaicin is known to be a powerful irritant that can cause selective degeneration of sensory neurons that mediate chemogenic or trigeminal pain. Capsaicin and its derivatives are principally used as an irritant; a flavorant from about 1 part in 100,000 parts; an animal repellent (U.S. Pat. Nos. 5,322,862 and 5,456,916); an antifoulant (U.S. Pat. No. 5,397,385); a carminative; in neural biological research (U.S. Pat. No. 5,094,782); and in pharmaceuticals (U.S. Pat. No. 5,403,868). Both the natural and synthetic compounds of Capsaicin have been found to be very effective for these uses. Although both denatonium compounds and capsaicin compounds provide an offensive flavor and are therefore useful as aversive agents, a new and useful compound exhibiting an enhanced bitter and/or sharp taste is most desirable. Accordingly, it is an object of the present invention to provide a new compound, Denatonium Capsaicinate, that is effective in very low concentrations to provoke a bitter and/or spicy, pungent flavor and/or to produce a chemogenic effect. Web site: http://www.delphion.com/details?pn=US05891919__
•
Enhanced transdermal anesthesia of local anesthetic agents Inventor(s): Jun; H. Won (Athens, GA), Kang; Lisheng (Athens, GA) Assignee(s): The University of Georgia Research Foundation, Inc. (Athens, GA) Patent Number: 6,299,902 Date filed: July 19, 1999 Abstract: A novel topical anesthetic preparation is characterized by improved transdermal absorption and efficacy. In a preferred embodiment, the topical preparation
Patents 105
contains at least one local anesthetic agent and at least two melting point depressing agents. Also provided is a two-phase liquid composition that contains aqueous and oil phases, the oil phase having a relatively high concentration of a local anesthetic agent to enhance transdermal absorption and efficacy when incorporated into a topical anesthetic preparation. A preferred topical anesthetic preparation includes lidocaine or tetracaine, thymol or menthol, and ethyl alcohol or isopropyl alcohol. The preparation is expected to be safe and effective in obtaining transdermal anesthesia on intact skin and mucous membrane of adults, children, infants and newborns. Excerpt(s): The search continues for a safe and effective topical anesthetic preparation that can ease the pain during dermal procedures, such as venipuncture, intravenous cannulation, punch biopsy and other small incisions, vaccination, and circumcision. A preparation that is safe for use in newborns is especially needed, since circumcision remains a common medical procedure performed on newborns, and existing scientific evidence demonstrates potential medical benefits of newborn male circumcision. Unfortunately, circumcision of infants is typically performed without any pain-relief treatment even though the American Academy of Pediatrics recommends procedural analgesia (AAP Circumcision Policy Statement, March 1999, pp. 686-693) because safe and effective topical preparations are not currently available. Metabolites of prilocaine, however, are known to be responsible for methemoglobinemia, a serious condition characterized by the ferric form of hemoglobin with impaired oxygen-carrying capacity (B. Jakobson et al., Acta Anaesthesialogica Scandinavica 29: 453-455 (1985)). As a result, the use of EMLA in young children has been severely restricted. For example, in the United States, EMLA is currently contraindicated in infants under 3 months old (M. Buckley et al., Drugs 46:126-151 (1993)), and in infants up to 1 year of age who are also receiving methemoglobin-inducing agents (Physician's Desk Reference, 49.sup.th Ed., Medical Economics Data Production Company, Montvale, N.H. (1995)). In the United Kingdom, EMLA is not approved for use in children under 1 year of age (S. Russell et al., Drug Safety 16:279-287 (1997)). Also, the Drug Information Handbook, 4.sup.th Ed. (1996-1997), published by the American Pharmaceutical Association, states that EMLA cream should not be used in infants under the age of 1 month. Very young patients, and patients with glucose-6-phosphate deficiencies, show increased susceptibility to methemoglobinemia. Lidocaine, on the other hand, is safe and is the most widely used local anesthetic agent. However, due to low permeability of lidocaine through the stratum corneum, the efficacy of lidocaine alone for topical anesthesia through intact skin has to date been extremely disappointing. Conventional lidocaine creams may be readily prepared by simply dissolving lidocaine in a suitable pharmaceutical oil and emulsified, but these creams can not effectively deliver lidocaine for transdermal anesthesia on intact skin. Efficacy can only be achieved when the concentration of lidocaine in the topical formulation is unacceptably high (e.g., greater than about 30% by weight), posing a risk of systemic toxicity. Limited by the intrinsic solubility of lidocaine in pharmaceutical oils, lidocaine concentration in the oil phase of conventional creams cannot reach the concentration that is necessary for effective transdermal delivery. Web site: http://www.delphion.com/details?pn=US06299902__
106
•
Lidocaine
External preparation for application to the skin containing lidocaine Inventor(s): Akazawa; Mitsuji (Kagawa-ken, JP), Iwamoto; Kiyomi (Kagawa-ken, JP), Konishi; Ryoji (Kagawa-ken, JP), Ono; Masahiro (Kagawa-ken, JP), Seki; Michiko (Kagawa-ken, JP) Assignee(s): Teikoku Seiyaku Kabushiki Kaisha (Kagawa-Ken, JP) Patent Number: 5,827,529 Date filed: June 10, 1994 Abstract: An external preparation for application to the skin containing lidocaine which comprises a drug-retaining layer placed on a support, wherein said drug-retaining layer comprises an adhesive gel base and 1 to 10% by weight of lidocaine, said base comprising a water-soluble high molecular weight substance, water and a waterretaining agent, which can release the active lidocaine gradually and constantly so that lidocaine is transdermally absorbed for a long period of time. Excerpt(s): The present invention relates to an external preparation for application to the skin containing lidocaine, more particularly, to an external preparation for application to the skin wherein lidocaine or a salt thereof as an active ingredient is dispersed or dissolved in a water-soluble high molecular weight substance in an adhesive gel base which is spread onto a support, and said active ingredient can be gradually and constantly released from the preparation stably so that it can be transdermally absorbed for a long period of time. In recent years, there have been conducted nerve block therapy, acupuncture, iontophoresis therapy, or administration of central analgesics or antidepressants in order to cure herpes zoster neuralgia and postherpetic neuralgia which occur in the aged at a relatively high frequency. Typical drug used in nerve block therapy is lidocaine. Lidocaine, which has been developed as local anesthetics, has surface, infiltration and conduction anesthetic actions and has been mainly used as surface anesthetics in the field of dentistry. Lidocaine is widely used as a primary drug for treatment of extrasystole, acute myocardial infarction, and ventricular arrhythmia occurred in surgical operation of heart. Web site: http://www.delphion.com/details?pn=US05827529__
•
Fast-acting pharmaceutical compositions and methods of use Inventor(s): McKay; Douglas William (450 Moosa Blvd., Suite C, Eunice, LA 70535) Assignee(s): none reported Patent Number: 6,569,839 Date filed: November 30, 1999 Abstract: A pharmaceutical composition comprising at least one local anesthetic, at least one anti-inflammatory agent and at least one antibiotic are disclosed. The local anesthetic has a peak effect no later than about 10 minutes after administration to a mammal, and the anesthetic and anti-inflammatory have a half-life of no greater than about 36 hours after administration. The pharmaceutical composition, thus, advantageously provides rapid relief of pain with a substantially low residual accumulation of active components so that the pharmaceutical composition can be repeatedly or continuously administered to a wound. Embodiments include preparing a medicinal solution including Lidocaine as the local anesthetic, Hydrocortisone sodium succinate as the anti-inflammatory agent, Chloramphenicol as the antibiotic agent and,
Patents 107
optionally, Heparin as an anticoagulant. The medicinal solution is continuously administered to treat a wound of a mammal to maintain a constant positive physiological pressure in the treated wound at a pressure to enable permeation of the medicinal solution and fluids from the wound with concomitant periodical suctioning of debris from the wound. Excerpt(s): The present invention relates to pharmaceutical compositions useful for the treatment of a wound or joint, with particular applicability to post operative closed muscular skeletal wounds. The pharmaceutical composition provides alleviation of pain, while promoting healing of the wound and early rehabilitation. Of major concern in the care of wounds, such as incurred in joint surgery, are relief of post-operative pain, avoidance of infection, hastening of healing, early joint motion, and a decrease in the length of necessary hospital services. Traditional post-operative management of orthopaedic wounds or traumatic wounds have varied in approach. However, an important consideration in the management of wounds is to prevent the painful accumulation of blood and debris and to prevent infection following the formation of an open wound. Pain relief and reduced swelling can be minimized by leaving a surgical wound or traumatic wound open thereby encouraging the free flow of debris and accumulated fluid out of the wound. Irrigation of the open wound with a sterile solution further promotes the removal of debris, blood, extra-cellular fluid, etc. The same debris and blood in an open wound, however, provide an excellent culture medium for bacterial growth and, hence, such techniques invite infection and promote contamination. Wound closure, conversely, prevents the beneficial flow of debris and fluid from the wound with concomitant pain relief but advantageously reduces the occurrence of bacterial infection and otherwise exterior contamination. Web site: http://www.delphion.com/details?pn=US06569839__ •
Formulation for electrically assisted delivery of lidocaine and epinephrine Inventor(s): Chin; Ivan W. (Belmont, CA), Gyory; J. Richard (North Oaks, MN), Linkwitz; Andreas (San Carlos, CA), Thompson; Ronald V. (Coon Rapids, MN), Urbanski; Paul J. (Minneapolis, MN) Assignee(s): Alza Corporation (Mountain View, CA) Patent Number: 6,295,469 Date filed: November 14, 1997 Abstract: The invention relates to formulations for the electrically assisted transdermal delivery of lidocaine and epinephrine. The present invention further provides methods and devices for the electrically assisted delivery of local anesthetics, preferably lidocaine. Excerpt(s): The present invention relates to non-invasive, electrically-assisted delivery of lidocaine through a body surface such as intact skin. Anesthetics are drugs which produce anesthesia, a condition characterized by the inability to appreciate sensation. Two types of anesthesia are generally recognized: local anesthesia and general anesthesia. In local anesthesia, the anesthesia is confined to a portion of the body, whereas in general anesthesia, the anesthesia extends to the entire body. Local anesthetics reversibly block impulse conduction in peripheral nervous tissue, thereby producing a transient loss of sensation in a circumscribed area of the body without causing a general loss of consciousness. This action can be used to block pain sensation
108
Lidocaine
to a specific area of the body. Hence, local anesthetics are used to prevent pain in surgical procedures, dental manipulations, injury and disease. Web site: http://www.delphion.com/details?pn=US06295469__ •
Formulations of haloalkylamines and local anesthetic and methods for the treatment of reflex sympathetic dystrophy (RSD) Inventor(s): Inchiosa; Mario (Woodclif Lake, NJ), Mustafa; Kamil (Bronxville, NY) Assignee(s): New York Medical College (Valhalla, NY) Patent Number: 5,898,035 Date filed: October 22, 1996 Abstract: The present invention pertains to the field of pain management in medicine. Methods for treating reflex sympathetic dystrophy (including causalgia) are provided, in which a haloalkylamine a adrenergic blocking agent and a local anesthetic are administered to the affected limb by intravenous regional block. Formulations which can be used in these methods are also provided. In a preferred embodiment, phenoxybenzamine and either lidocaine or procaine are administered to the affected limb using a Bier block procedure. Excerpt(s): The invention pertains to the field of pain management in medicine. More specifically, the invention pertains to the field of managing and treating the pain and other symptoms resulting from the disorder known as reflex sympathetic dystrophy (RSD). Reflex Sympathetic Dystrophy, or "RSD," is a common but poorly recognized chronic syndrome that most often occurs following traumatic injury to a limb. It is also associated with heart attack (myocardial infarction) and certain disorders of the nervous system. RSD includes disorders that were in the past known as causalgia, minor causalgia, post-traumatic pain syndrome, post-traumatic spreading neuralgia, posttraumatic vasomotor disorders, post-traumatic painful arthrosis, Sudeck's atrophy, sympathalgia, shoulder-hand syndrome, chronic traumatic edema, post-traumatic edema, autonomic hyper-reflexia, and reflex dystrophy, among others. (See: Bonica, J. J., The Management of Pain, Second Ed., Lea & Febiger, Philadelphia, 1990, pp. 220-243). The International Association for the Study of Pain continues to distinguish "causalgia," which is a more severe disorder often caused by nerve injury from war-inflicted shrapnel or projectile wounds, and which has some distinctive symptoms such as psychological disturbances that apparently result from the continuous, intense pain. However, most clinicians and researchers recognize that causalgia is symptomologically quite similar to the reflex sympathetic dystrophies, that it is treated in essentially the same way, and that it likely results from the same underlying mechanisms. Therefore, we hereinafter use the terms reflex sympathetic dystrophy and "RSD" to mean all of the above-mentioned disorders, including causalgia, as well as other disorders that fall within the symptomological definition of RSD. Although many theories have been advanced, the mechanism that causes RSD is not clearly understood. One recent view is that RSD is caused by increased firing of peripheral nerves due to increased sensitivity, which in turn causes altered responses by the spinal cord, which then responds abnormally to signals from the brain stem and cortex. (See: Schwartzman, R. J. and T. L. McLellan, Reflex Sympathetic Dystrophy, Arch. Neurol. 44:555-561). Web site: http://www.delphion.com/details?pn=US05898035__
Patents 109
•
Hemorrhoidal ice-treatment device Inventor(s): Wierson; Mark (9871 N. Banditt Trail, Tucson, AZ 85742) Assignee(s): none reported Patent Number: 5,707,645 Date filed: September 10, 1996 Abstract: A small, reusable, previously cooled or frozen bladder that is applied to the anal area of a user. The bladder consists of two two-ply sheets of a flexible, semi-porous material, such as polyethylene, hermetically heat sealed together at the edges to form an internal cavity. The cavity contains a cold-temperature storage means, such as water, glycerol, a combination thereof, or other chemical slurry, and a medicinal agent, such as witchhazel, shark oil, yarrow, other astringents, and lidocaine or other pain relievers. Excerpt(s): This invention pertains to the general field of methods and devices for treating ailments with ice packs. In particular, it concerns a novel device for providing ice treatment and medication for hemorrhoids in a patient. Hemorrhoids are painful swellings or tumors of a vein in the region of the anus that cause pain, itching, bleeding, and general discomfort. Many products and therapies for the treatment of hemorrhoids exist, including salves, ointments, solution-impregnated pads, the application of heat, and various surgical procedures. Most of the available over-the-counter preparations contain an analgesic component, a lubricant to ease the strain and pressure associated with bowel movements, and/or a topical steroid in low concentration. These preparations provide only temporary relief from hemorrhoidal discomfort, and they do not induce a significant reduction in swelling or edema, or reduce any of the other actual causes of the pain. Prescription preparations generally contain the same types of ingredients as the over the counter products, merely in stronger concentrations. Web site: http://www.delphion.com/details?pn=US05707645__
•
Lidocaine aerosol anaesthetic Inventor(s): Henry; Richard A. (7 Toronto Street, Kingston, Ontario, CA) Assignee(s): none reported Patent Number: 5,593,661 Date filed: March 17, 1995 Abstract: The composition of the present invention combines the local anaesthetic lidocaine in free base form and the non-CFC aerosol propellant HFC-134a(1,1,1,2tetrafluoroethane; CF.sub.3 CH.sub.2 F) or HFC-227 (1,1,1,2,3,3,3-Heptafluoropropane; (CF.sub.3 CHFCF.sub.3), or a combination thereof, thus incorporating previouslyunattainable amounts of the lidocaine free base in solution in a non-CFC aerosol propellant. This particular form of relatively-concentrated cosolvent-free anaesthetic permits improved inhalation delivery to the airway and lung, and topical airway local anaesthesia is thus readily provided. A method in accordance with the invention provides for release of the anaesthetic in aerosolized form of selected dosage from a canister containing the pressurized local anaesthetic composition into a patient's respiratory system directly or by way of an airway. Excerpt(s): The present invention particularly concerns providing a local anaesthetic of aerosol form for topical airway anaesthesia and more particularly an aerosol dispensable composition of free base lidocaine and a suitable HFC propellant. The
110
Lidocaine
propellants are hydrofluorocarbon HFC-134a (1,1,1,2-tetrafluoroethane; CF.sub.3 CH.sub.2 F ) and hydrofluorocarbon HFC-227 (1,1,1,2,3,3,3-Heptafluoropropane; CF.sub.3 CHFCF.sub.3 ); or a combination thereof. The invention also relates to improvements in the delivery of such topical local anaesthetic to a human airway. Adverse physiological and neuromuscular response to laryngoscopy and intubation remains a significant problem of airway manipulation, both during anaesthesia and other airway diagnostic procedures. This is more fully discussed in the above-identified pending application the substance of which is incorporated hereby by reference thereto. There is a need for an improved method of delivering a topical anaesthetic to a patient's airway and this is partly addressed by the aforementioned application. There further is need of a topical anaesthetic in suitable form for delivery into a patient's airway. Web site: http://www.delphion.com/details?pn=US05593661__ •
Method and analgesic preparations for sustained and extended corneal analgesia with subanesthetic concentrations of lidocaine Inventor(s): Shahinia, Jr.; Lee (1506 Country Club Dr., Los Altos, CA 94024) Assignee(s): none reported Patent Number: 6,350,781 Date filed: August 25, 2000 Abstract: A preparation suitable for sustained and extended corneal analgesia and for repeated administration consisting of subanesthetic concentrations of lidocaine. A method for corneal analgesia by administering to a patient an ophthalmic analgesic solution containing lidocaine in subanesthetic 0.4% concentration. Excerpt(s): The current invention concerns a method for ophthalmic analgesia achieved with nontoxic subanesthetic concentration of multiple doses of topically administered lidocaine. In particular, the invention concerns administration of diluted topical lidocaine preparation comprising about and up to about 0.4% (4000.mu.g/ml) of lidocaine and a topical ophthalmic preparation for corneal analgesia having a fast onset of pain relief and extended duration of the corneal analgesia. The lidocaine preparation may be administered for several months without accompanying toxic symptoms. Trauma to the eye, particularly corneal injury and abrasion, tends to be excruciatingly painful. While many anesthetic agents such as proparacaine, cocaine, procaine, tetracaine, hexylcaine, bupivacaine, lidocaine, benoxinate, mepivacaine, prilocaine and etidocaine, to name a few, are well known to attain temporary anesthesia and suppression of pain, concentrations of these agents needed to achieve corneal anesthesia are between 0.25% and 4%. At these concentrations, these agents can only be administered for a very short period of time necessary to achieve local anesthesia and permit performance of ophthalmic procedures such as examination of a painful eye, measurement of intraocular pressure, gonioscopic examination, removal of foreign bodies and sutures from the cornea, diagnostic conjunctival and corneal scrapings, radial keratotomy, and other surgical procedures. The onset of the anesthesia is very rapid, typically under 15 seconds, and typically lasts for about 10-30 minutes. Unfortunately, application of local anesthetics to the cornea at these concentrations causes the development of temporary superficial corneal epithelial lesions. Upon repeated application for prolonged anesthesia, these lesions progress to extensive erosions of the corneal epithelium and grayish infiltrates of the corneal stroma which can lead to permanent scarring and loss of vision. Prolonged application, of local anesthetics is further associated with delayed corneal reepithelialization after
Patents 111
wounding, altered lacrimation and tear film stability, corneal swelling, and disruption of epithelial cell mitosis and migration. Web site: http://www.delphion.com/details?pn=US06350781__ •
Method for treating nerve injury pain associated with shingles (herpes-zoster and post-herpetic neuralgia) by topical application of lidocaine Inventor(s): Hind; Harry (Los Altos, CA) Assignee(s): Hind Health Care, Inc. (Los Altos, CA) Patent Number: 5,589,180 Date filed: March 5, 1996 Abstract: Methods and compositions are offered for reducing nerve injury pain associated with shingles (herpes-zoster and post-herpetic neuralgia), where intradermal delivery of lidocaine is maintained for a predetermined period of time. The lidocaine appears to specifically affect the damaged nerve fibers, while leaving the undamaged and normal nerve fibers with retention of response to other stimuli. Lidocaine formulations are provided which allow for the necessary dosage of the lidocaine in the dermis during the period of treatment. The formulation may be covered with an occlusive or non-occlusive dressing, which protects the lidocaine formulation from mechanical removal and enhances the transport of the lidocaine into the dermis. Long term relief is realized after maintenance of the administration of lidocaine has been terminated. Excerpt(s): The field of this invention is extended pain relief methods and compositions. The mechanism of pain generation in post-herpetic neuralgia is unknown. Post-herpetic neuralgia (PHN) begins with a cutaneous rash and the chronic state is notable for skin scarring and painfully sensitive skin (allodynia). Although the initial outbreak may be widespread, occasionally appearing to cover more than the area of skin innervated by a single dorsal root ganglion, most PHN patients are able to localize a limited area of skin as the source of their pain. PHN patients nearly always have a sensory deficit in the region obtained. The majority of work carried out on topical agents for analgesia in recent years has been in patients with PHN. Other conditions, particularly diabetic neuropathy, have been treated in clinical trials and clinical practice with topical agents, primarily capsaicin. Topical therapies represent a very attractive alternative to oral medications for conditions like PHN. The primarily elderly patients with PHN frequently cannot be treated with tricyclic antidepressants because of pre-existing cognitive impairment, cardiac disease, or systemic illness. Diabetic autonomic disfunction may significantly enhance orthostatic hypotension from tricyclic antidepressants. Side effects like constipation, dry mouth and sedation may prove so bothersome that compliance becomes a major problem in therapy. Anticonvulsants are of uncertain efficacy in PHN, though carbamazepine and antiarrhythmics like mexiletine are effective for diabetic neuropathy. Non-narcotic analgesics are rarely effective and benzodiazepines have been proven ineffective. Opioids may be effective, but have not been adequately evaluated as long term treatment for PHN or diabetic neuropathy. Web site: http://www.delphion.com/details?pn=US05589180__
112
•
Lidocaine
Method for treating pain associated with herpes-zoster and post-herpetic neuralgia Inventor(s): Hind; Harry (Los Altos, CA) Assignee(s): Hind Health Care, Inc. (Los Altos, CA) Patent Number: 5,601,838 Date filed: May 18, 1990 Abstract: A method is offered for reducing the pain associated with herpes-zoster and post-herpetic neuralgia. The method consists of administering a composition incorporating a transdermal delivery system for the administration of Lidocaine to areas of the body afflicted by herpes-zoster and post-herpetic neuralgia enclosed with an occlusive dressing or a plaster dressing. Excerpt(s): The subject of this application concerns methods for treatment of pain associated with herpes-zoster and post-herpetic neuralgia. The acute neuralgia produced by recrudescence of latent varicella-zoster virus (familiarly known as chicken pox virus) is called herpes-zoster, or "shingles". Reactivation of the latent virus in a dorsal root ganglion results in the transport of live virus along the associated sensory nerves (dermatome). In addition to severe pain in the distribution of affected nerves, herpes zoster is also associated with nervous system complications such as myelitis, stroke, ocular damage, skin damage, and, most commonly, post-herpetic neuralgia-defined as pain that persists in the involved dermatome for more than 1 month after healing of the skin lesions. Web site: http://www.delphion.com/details?pn=US05601838__
•
Method for treating painful conditions of the anal region and compositions therefor Inventor(s): Fogel; Barry S. (Providence, RI) Assignee(s): Synchroneuron, LLC (Waban, MA) Patent Number: 6,159,944 Date filed: February 27, 1998 Abstract: Method and composition for treating painful conditions of the body, particularly the anal region. The compositions include a combination of nitroglycerin and sucralfate or a combination of nitroglycerin, lidocaine and sucralfate. The compositions may be included in a petrolatum base along with a water soluble lubricant. These compositions have been found effective in treating painful conditions in the anal region, such as anal fissures, inflamed or recently thrombosed hemorrhoids, and other chronic anal pain. Excerpt(s): This invention relates to methods and compositions for treating painful conditions of the anal region and more particularly for treating anal fissures, thrombosed or inflamed hemorrhoids, for pain associated with ligation of internal hemorrhoids and for chronic anal pain. Anal fissures can be an extremely painful condition. The primary reason for severe pain is spasm of the anal sphincter. This spasm causes ischemia, which both produces pain and interferes with healing (Sharp, American Journal of Surgery, 1996; Volume 171, pages 512-515; Schouten et al., 1993, Scandinavian Journal of Gastroenterology, Volume 31, Supplement 218, pp. 78-81). Spasm of the anal sphincter also plays a role in the pain of inflammatory conditions of the anal region, such as inflamed or recently thrombosed hemorrhoids (Janicke & Pundt, 1996, Emergency Medicine Clinics of North America, Volume 14, pp. 757-788). See also,
Patents 113
Madoff, R D., "Pharmacologic Therapy for Anal Fissure," New England Journal of Medicine January 1998 22:338(4) 217-20. Effective treatments for anal fissures, whether medical or surgical, involve relaxation of the spastic muscle. These treatments include lateral sphincterotomy, injection of the sphincter with botulinum toxin, and application of nitroglycerin ointment. A recent review by Sharp of treatment for chronic anal fissures recommends beginning with nitroglycerin ointment. If the fissure has not healed in six weeks, botulinum toxin injections are given. That review notes that "considerable educational effort is required to successfully adjust the dose" of nitroglycerin (Sharp, 1996, ibid.). It states that nitroglycerin "will often eliminate the severe pain of fissure-in-ano in 1 day". Schouten et al. (1993, ibid.) used topical isosorbide dinitrate to treat chronic anal fissures, attaining pain relief" within 10 days". Lund & Scholefield (1997, Lancet, Volume 349, pp. 11-14) reported a randomized controlled trial of 0.2% nitroglycerin ointment for anal fissure. At 2 weeks, pain on defecation, as measured by a visual analogue scale (0=no pain, 100=worst pain ever), averaged 33.5 in the treated group, compared with 48.0 in a group treated with placebo, and 73.0 in the same patients at baseline. Web site: http://www.delphion.com/details?pn=US06159944__ •
Non-stinging styptic pencil Inventor(s): Kaplan; Jeffrey (P.O. Box 11106, Ft. Laud, FL 33339) Assignee(s): none reported Patent Number: 5,955,112 Date filed: February 11, 1998 Abstract: A non-stinging styptic composition in the form of a water soluble resin coated cast pencil, for stopping bleeding from cuts and nicks received during shaving. The composition comprises aluminum sulfate, aloe, glycerine, lidocaine and polyethylene glycol 400. Excerpt(s): This invention relates to an improved styptic pencil composition for use primarily in connection with shaving to rapidly and effectively curtail bleeding from minor nicks and cuts, which when applied does not sting, irritate or cause staining on clothing. Nicks and cuts on the chin, face and other areas are a virtually inevitable consequence of regular blade shaving. Nicks and cuts can also be a significant problem for woman when shaving their legs and underarms. Shaving cuts, especially in the area of the face tend to bleed profusely, and it can be quite difficult to halt the flow of blood. The use of styptic or astringent compositions is well established in the art. The principal astringent chemicals are compounds of aluminum, zinc, manganese, iron, and bismuth, and other chemical groups that contain these metals (such as permanganates). Web site: http://www.delphion.com/details?pn=US05955112__
•
Preemptive analgesic agent and methods of use Inventor(s): Zappala; Stephen M. (98 Rattlesnake Hill Rd., Andover, MA 01810) Assignee(s): none reported Patent Number: 6,329,398 Date filed: March 30, 2001
114
Lidocaine
Abstract: A pharmacological agent for use as preemptive analgesia, comprising, 1% lidocaine HCL and 0.25% bupivacaine HCL in a ratio sufficient to provide analgesic effect quickly and for an extended period of time, preferably equal to or less than 10:1. Excerpt(s): This invention relates to analgesia and more specifically to preemptive analgesia used as an adjunct to reduce perioperative pain and methods of using the analgesia. It is known that perioperative pain may be reduced by beginning pain reduction therapy before surgery. This early intervention therapy is commonly known as preemptive analgesia, the purpose of which is to reduce the hypersensitization of nociceptors by blocking pain impulses from ever reaching the brain. Essentially, preemptive analgesia prevents the activation of the nociceptors before activation can occur. Preemptive analgesia has received widespread acceptance as an adjunct to reduce perioperative pain in patients who undergo surgical procedures as generally disclosed by Mayer et al. in U.S. Pat. No. 5,502,058. The technique is well accepted and involves the pharmacological interruption of afferent neurons to the dorsal horns of the spinal cord prior to the delivery of painful stimuli, such as a surgical incision. The anesthetic concept can be applied to most surgical procedures, minimizing postoperative pain as well as the necessity for narcotic or parenteral analgesia. Moreover, patients treated with preemptive analgesia have experienced reduced hospitalizations and a much shorter convalescence. Web site: http://www.delphion.com/details?pn=US06329398__ •
Rescue device for bee attacks Inventor(s): Ogram; Karen (780 S. Freeman, Tucson, AZ 85748) Assignee(s): none reported Patent Number: 6,029,863 Date filed: October 5, 1998 Abstract: A rescue apparatus to be used in the event of a bee attack in which a handheld cannister sprays a soapy or foamy mixture against the animal being attacked by the bees. The foam is ejected at least three feet to protect the rescuer from the bees. Also, the foam contains a local anaesthetic such as lidocaine hydrochloride and an insecticide. The local anaesthetic is used to both keep the foam from stinging the victim's eyes and also to deaden the site of the bee attack. The insecticide kills the bees to keep them from further attacks. The preferred insecticide is not harmful to humans. Excerpt(s): This invention relates generally to safety apparatus and more particularly to rescue apparatus for bee attacks. While bees have proven to be of extreme importance within the agricultural industry, they have not always been viewed as "friendly". Even the relatively benign "European" bee is known to swarm and to attack without any obvious provocation. This danger of bee attacks has only escalated as "Africanized" bees have migrated into the United States and have interacted with the "European" bees. The "Africanized" bees, while no more venomous than the "European" are known to attack with less provocation and to attack in heretofore unforeseen numbers. The assault by the "Africanized" bees is so intense and devoted, that its victims are often simply overwhelmed. Web site: http://www.delphion.com/details?pn=US06029863__
Patents 115
•
Stable, long acting salts of carboxamides for the treatment of joint disease Inventor(s): Ahmed; Imran (East Lyme, CT) Assignee(s): Pfizer Inc (New York, NY) Patent Number: 5,968,969 Date filed: August 19, 1997 Abstract: Calcium, magnesium, lidocaine and benzathine salts of 2-oxindole-1carboxamides are useful for the treatment of joint disease by intra-articular administration. Excerpt(s): Allen and O'Neill, U.S. Pat. No. 5,036,099 disclosed an anhydrous crystalline form of the sodium salt of tenidap which is nonhygroscopic and stable in dosage forms. Tenidap and other 2-oxindole-1-carboxamides are acute phase protein modulating antiinflammatory drugs which are useful for the treatment of rheumatoid arthritis. Similar to the steroids, these compounds have been shown to cause rapid reduction in acute phase proteins in arthritic patients. Intra-articular administration of these compounds relieves joint pain and swelling while minimizing systemic drug exposure. Prolongedacting formulations employing sparingly soluble salts are required for intra-articular administration. wherein the substituent on said substituted phenyl, said (substituted phenyl)alkyl and said (substituted phenoxy)alkyl is selected from the group consisting of fluoro, chloro, bromo, alkyl having 1 to 4 carbons, alkoxy having 1 to 4 carbons and trifluoromethyl, n is zero, 1 or 2; Q is a divalent radical derived from a compound selected from the group consisting of furan, thiophene, pyrrole, pyrazole, imidazole, thiazole, isothiazole, oxazole, isoxazole, 1,2,3-thiadiazole, 1,3,4-thiadiazole, 1,2,5thiadiazole, tetrahydrofuran, tetrahydrothiophene, tetrahydropyran, tetrahydrothiopyran, pyridine, pyrimidine, pyrazine, benzo[b]furan and benzo[b]thiophene; and R.sup.O is hydrogen or alkyl having 1 to 3 carbons. Web site: http://www.delphion.com/details?pn=US05968969__
•
sustained release non-steroidal, anti-inflammatory and lidocaine PLGA microspheres Inventor(s): Setterstrom; Jean A. (Alpharetta, GA), Van Hamont; John E. (Ft. Meade, MD), Vaugn; William M. (Silver Spring, MD) Assignee(s): The United States of America as represented by the Secretary of the Army (Washington, DC) Patent Number: 6,217,911 Date filed: July 5, 1996 Abstract: A controlled release microcapsule pharmaceutical formulation for burst-free, sustained, programmable release of a non-steroidal, antiinflammatory drug over a duration from 24 hours to 2 months, comprising: a non-steroidal, antiinflammatory drug and a blend of biocompatible, biodegradable poly (lactide/glycolide). Excerpt(s): This invention relates to providing novel pharmaceutical compositions for local delivery and sustained release of non-steroidal, anti-inflammatory drugs (NSAIDs) from biocompatible, biodegradable poly(DL-lactide-co-glycolide) (PLGA) microspheres. The resulting product is applied locally into soft tissues surrounding a surgical incision or traumatic wound site where it will locally sustain release of the NSAID. The invention also relates to providing novel pharmaceutical compositions for local delivery and sustained release of lidocaine PLGA microspheres. Non-steroidal anti-
116
Lidocaine
inflammatory drugs (NSAIDS) have been effective in reducing inflammation and inducing analgesia; however, the conventional oral dosage forms of these drugs characteristically have short half-lives and irritate the gastrointestinal mucosa. Further, currently available slow release oral dosage forms, such as Biovail (enteric coated, double-layer tablets which release the drug for 12-24 hours) still result in inefficient systemic delivery of the drug and potential gastrointestinal irritation. Web site: http://www.delphion.com/details?pn=US06217911__ •
Tissue-numbing anesthetic articles Inventor(s): Jackson; Richard R. (One Atlantic Ave., Swampscott, MA 01907), Williams; John N. (Concord, MA) Assignee(s): Jackson; Richard R. (Swampscott, MA) Patent Number: 5,810,786 Date filed: March 25, 1996 Abstract: A drug delivery system comprising propathenone or lidocaine dissolved in thermoplastic resin is shown to be useful for prolonged release antiahrrythmia medications. More generally, a compound with topical anesthetic and plasticizing properties, or another drug having a similar structures containing an aromatic ring, is dissolved in polymeric material. Extrusion, co-extrusion, coating and diffusion techniques to form orally digestible granules, fibers, films and tubes such as endotracheal tubes, drainage tubes and other medical devices with the material containing drug are disclosed. Diffusion techniques in which the drug diffuses into the thermoplastic is also disclosed. A hydrophobic anesthetic or similar compound such as the base form of lidocaine or propathenone is used which is more soluble in the polymeric material than in water. Prilocaine base and dibucaine base are also used in examples. A water soluble form of the drug, achievable by reacting the base form of the drug dissolved in the polymer, is provided, e.g. at an exposed surface, to enable rapid onset of anesthesia or dosage. Balloons, films and extruded cross sections are shown. Barrier and metering layers control the direction and rate of application of the anesthetic or drug.Compresses and wound dressings containing thermoplastic constituents in which a drug is dissolved provide prolonged administration of anesthetics and other drugs. An ointment or other fluid containing an ionic surfactant assists the transfer of the drug from the thermoplastic to the body. Excerpt(s): The invention relates to drug compositions and delivery systems, and the methods of their manufacture and use. In one respect, the invention relates to compositions and methods for specifically enabling release of the drug propafenone or lidocaine, administered as an antiarrhythmic. The invention also relates to drug delivery systems for delivering propafenone or lidocaine to the body over prolonged periods for other therapies. Web site: http://www.delphion.com/details?pn=US05810786__
Patents 117
•
Topical anesthetic comprising lidocaine, adrenaline, and tetracaine, and its method of use Inventor(s): Ernst; Amy A. (26 Maryland Dr., New Orleans, LA 70124) Assignee(s): none reported Patent Number: 5,585,398 Date filed: July 15, 1994 Abstract: A topical anesthetic includes about 1-10% by weight lidocaine hydrochloride, about 0.01-0.10% by weight adrenaline, and about 0.25-4% by weight tetracaine hydrochloride, preferably in an aqueous base with about 2% benzyl alcohol or in a gel including about 3% hydroxyethyl cellulose. The topical anesthetic has been found to be at least as effective as TAC (tetracaine hydrochloride, adrenaline, cocaine), but with fewer harmful side effects and at a greatly reduced cost (about 1/10 of the cost of TAC). Excerpt(s): The present invention relates to topical anesthetics. More particularly, the present invention relates to topical anesthetics for lacerations. There has been a long-felt need for a topical anesthetic that affords painless, safe application, does not contain narcotics or controlled substances, and has a maximum safety with complete anesthesia. Several studies since that of Pryor et al. have shown varying efficacy of the TAC solution, and have compared the efficacy of TAC to injected lidocaine in application and anesthetic properties (2-5). Web site: http://www.delphion.com/details?pn=US05585398__
•
Topical anesthetic formulation Inventor(s): Castillo; James G. (15412-15.sup.th St., Lutz, FL 33549) Assignee(s): none reported Patent Number: 5,993,836 Date filed: April 28, 1998 Abstract: A topical, transdermal anesthetic comprising a eutectic mixture of, preferably, lidocaine and prilocaine in a ratio of about 3:1 by weight, incorporated within a lipophilic base. In addition to the property of rapid-onset, the formulation of the present invention has high storage stability and is less restricted by dosage limitations of other prilocaine-containing transdermal anesthetics and is, advantageously, not dependent upon occlusive dressing for optimal transdermal absorption. Excerpt(s): This invention relates to a new formulation of a topical anesthetic and, more particularly, to a fast acting transdermal, topical anesthetic formulation having improved stability. Surgical techniques such as cosmetic resurfacing involving surgical ablation with an Erbium:YAG laser, and other laser procedures involving vaporization, excision, incision, and coagulation of soft tissue in medical specialties including dermatology, plastic surgery, podiatry, neurosurgery, gynecology, otorhinolaryngology (ENT), arthroscopy (knee surgery), and invasive and endoscopic general surgery, can only be performed after the highly sensitive nerve endings in the skin are anesthetized. The preferred method of administration of anesthetic is transdermally. Skin, however, is a formidable barrier to the absorption of analgesics. Because the skin must serve as a barrier to the ingress of pathogens and toxic materials, and the egress of physiologic fluids, the skin is highly impermeable. Impermeability allows the skin to preserve its own integrity while simultaneously maintaining the delicate dynamic electrolyte
118
Lidocaine
balance of the body. Therefore, the skin functions both as a containment mechanism and as a microbial, chemical, radiation and thermal barrier. Web site: http://www.delphion.com/details?pn=US05993836__ •
Topical anesthetic prophylaxis composition and the method for use thereof in scaling and polishing teeth Inventor(s): Penner; Russell Anthony (5359 Harvest Breeze Rd., Las Vegas, NV 89118) Assignee(s): none reported Patent Number: 6,187,294 Date filed: June 10, 1999 Abstract: A topical anesthetic/prophylaxis paste is provided that is effective at removing extrinsic stains and plaque on the teeth and at reducing discomfort during scaling procedures thereon by delivery of an anesthetic into the gingival sulcus. The paste includes at least one topical anesthetic, either 5% Lidocaine or 20% Benzocaine, at least one humectant, preferably a Polyethylene glycol in the amount of about 28 to about 42 percent by weight, at least one abrasive agent, preferably pumice in the amount of about 55 to about 65 percent by weight, and at least one sweetener, preferably Saccharin sodium in the amount up to about three percent by weight. A method of delivering the topical anesthetic/prophylaxis paste into the sulcus by a low speed handpiece with a prophylaxis angle and rubber cup is also provided. Excerpt(s): This invention relates generally to dental compositions and, more specifically, to a topical anesthetic prophylaxis composition and the method for use thereof in scaling and polishing teeth. The techniques of dental hygiene or prophylaxis are applied directly to the teeth, the gingiva, and the gingiva sulcus, anatomical structures well known to the professional oral health practitioner. Generally, the gingiva includes the free gingiva. The gingival sulcus is the crevice or groove between the free gingiva and the tooth. Optimum oral health may be substantially attained and maintained by complete and regular supragingival and subgingival scaling by a professional oral health practitioner such as a dental hygienist or dentist. After treatment by scaling or other periodontal therapy, the teeth are routinely polished. Polishing removes stains and plaque. Accompanied by the patient's therapeutic bacterial-plaque removal on a daily basis, inflammatory gingival and periodontal diseases may thus be substantially prevented. Web site: http://www.delphion.com/details?pn=US06187294__
•
Topical pharmaceutical preparation for fever blisters and other viral infections and method of use Inventor(s): Matheson, Jr.; Joe G. (419 Mitchell St., Ahoskie, NC 27910), Mizelle, Jr.; Louis E. (Rte. 2, Box 175, Ahoskie, NC 27910), Riddick; Kenneth B. (918 Liberty St., Ahoskie, NC 27910) Assignee(s): none reported Patent Number: 5,886,047 Date filed: December 6, 1993
Patents 119
Abstract: The present invention relates to a method and pharmaceutical composition for treating fever blisters or cold sores in mammals, and particularly in humans, by topically administering a pharmaceutical composition comprising ethyl alcohol in a concentration of at least 85% W/V and lidocaine in a concentration of 0.5-10% W/V at a periodicity of at least 10 to 12 times daily. Excerpt(s): This invention relates to a method and pharmaceutical composition for topically treating fever blisters or cold sores and other viral infections in mammals, and in particular in humans. In an effort to address the discomfort of fever blisters, cold sores and other lesions caused by Herpes-type viruses, many home remedies have been used over the years without any significant success. Also, commercial products have been developed in recent years to attempt to treat the viral infections. Representative of such products are the following: CAMPHO-PHENIQUE manufactured by Winthrop Consumer Products of New York, N.Y.; HERPECIN-L manufactured by Campbell Labs of New York, N.Y.; and BLISTEX manufactured by Blistex Incorporated of Oakbrook, Ill. Unfortunately, none of the commercial formulations have been found to be entirely satisfactory when used as topical preparations for treating humans for fever blisters or cold sores and other viral infections of both the single occurrence as well as recurrent type. Of interest, U.S. Pat. No. 4,628,063 to Haines et al. discloses that the use of lidocaine, and particularly lidocaine in combination with a pantothenic acid, is an effective anti-viral agent in use to treat Herpes virus infections in mammals and is particularly effective in the treatment of HSV oral and genital lesions on humans. Haynes et al. discloses that lidocaine, a local anesthetic agent, and pantothenic acid (Vitamin B5) have an anti-viral effect on mammals, including human beings. It is further disclosed that lidocaine administered in the form of a pharmaceutical formulation comprising lidocaine and pantothenic acid together with a pharmaceutically acceptable carrier is particularly effective when injected in a single daily dosage or topically applied in an ointment or solution form 3 to 4 times daily. Unfortunately, this formulation is not entirely satisfactory due to the inconvenience of injections and the lengthy time of therapy required for topical treatment. Web site: http://www.delphion.com/details?pn=US05886047__ •
Treatment of dermal tumors, warts, and viral infections of the respiratory tract in humans using heat-killed P. acnes Inventor(s): Edwards; Bobby G. (Salado, TX), Van Kampen; Kent R. (Hoover, AL) Assignee(s): The Van Kampen Group, Inc. (Hoover, AL) Patent Number: 6,726,913 Date filed: October 13, 2000 Abstract: Heat-killed, terminally sterilized saline suspensions of Propionibacterium acnes, Propionibacterium avidum, Propionibacterium lymphophilum, Propionibacterium granulosum, Cornynebacterium parvum, and Arachnia propionica are effective in treating viral infections of the respiratory tract in humans, and to induce the regression of dermal tumors and warts in humans. The potency of a saline suspension of heat-killed, terminally sterilized saline suspension of Propionibacterium acnes (P. acnes) was demonstrated through a laboratory animal challenge model. The P. acnes product is administered orally for the purpose of preventing or treating viral infections of the respiratory tract in man. The P. acnes preparation is intralesionally administered into dermal tumors, warts such as plantar warts, or other warts in people caused by the human papilloma virus, to cause regression of such dermal tumors and
120
Lidocaine
warts. The subcutaneous route of administration of the P. acnes product causes a systemic reaction that causes long-term warts to completely regress. Anesthetics such as Lidocaine may be added to the P. acnes product to prevent pain upon injection of this immune modulating preparation, while retaining the potency of the P. acnes product. Dose ranges have been established for the oral administration of the P. acnes product to treat viral infections, and for the subcutaneous and intralesional administration of the P. acnes product to treat dermal tumors and warts. Excerpt(s): The present invention relates to methods to treat viral infections, dermal tumors, and warts in humans using heat-killed bacterial compositions. Specifically, it relates to the subcutaneous or intralesional administration of heat-killed Propionibacterium acnes (P. acnes), to treat dermal tumors and warts, and to the oral administration of heat-killed P. acnes to treat virus induced infections of the respiratory tract in humans. The maintenance of a healthy and competent immune system is a prerequisite for resistance to and elimination of infectious and neoplastic diseases. Bacteria and their derivatives were among the first substances to be recognized as immunostimulators and are used as adjuvants in vaccines to boost the humoral immune response (e.g., complete Freund's adjuvant). Bacteria have also been used as non-specific enhancers of the immune system to increase resistance and rejection of cancers, parasites, and infectious organisms. Gram positive, whole-cell bacteria such as Propionibacterium acnes, Propionibacterium avidum, Propionibacterium lymphophilum, Propionibacterium granulosum, Cornynebacterium parvum and Arachnia propionica, when inactivated have been shown to be potent non-specific immune stimulants in animals and humans. Specifically Propionibacterium acnes (P. acnes) has been shown to stimulate antineoplastic activity, adjuvant activity, antiviral activity, antibacterial activity, and stimulate hematopoiesis. Web site: http://www.delphion.com/details?pn=US06726913__ •
Water-based formulation for the treatment of sunburn Inventor(s): Cohen; Peter D. (Edison, NJ), Haight; Carl (Lincoln Park, NJ) Assignee(s): Water-Jel Technologies, Inc. (Carlstadt, NJ) Patent Number: 5,558,914 Date filed: April 11, 1994 Abstract: This invention relates to a water-based formulation for the treatment and care of sunburn and, in particular, to a water-based formulation that is useful for decreasing the temperature at the surface of a sunburn and for reducing the pain and discomfort caused by sunburn. The preferred water-based formulation includes tea tree oil, spearmint oil, lidocaine HCl and a component reduces tackiness. Excerpt(s): The subject invention relates to a water-based formulation and method for the treatment of sunburn. Although there has been substantial effort in recent years to reduce or eliminate the risk of sunburn (erythema) produced by certain wavelengths in the ultraviolet (UV) region of the spectrum, there are still circumstances wherein skin becomes exposed to UV radiation. Such exposure may, in some cases, cause sunburn that needs to be treated. To be useful, a formulation that is intended for treatment of sunburn would preferably satisfy several objectives simultaneously. The main objectives of a formulation for the treatment of sunburn are to relieve pain, eliminate the source of heat, stop the burn progression and, if necessary, help prevent infection. Thus, a useful sunburn formulation preferably provides immediate relief from pain while also helping
Patents 121
to promote healing. In addition, a useful sunburn formulation preferably contains components that provide protection from bacteria to which the formulation may be exposed during storage or after its application. It is also desirable that the separate components of the formulation be combined in a reasonably convenient and costeffective process and that the composition, thus prepared, remains stable during storage. Finally, it is preferable that the sunburn formulation be contained in a carrier container so that the formulation may be conveniently delivered and applied when needed. In addition, it is desirable for health reasons, in some cases, to package the sunburn formulation in single-dose packaging so as to reduce the risk of contamination from one usage to the next. After application, it is also preferable that the sunburn formulation provide the relief and healing effects sought without producing an uncomfortable sticky sensation and without soiling or sticking to one's clothing. The sunburn formulation also preferably does not produce a residue that has to be subsequently washed or removed from the sensitive burned area. Web site: http://www.delphion.com/details?pn=US05558914__
Patent Applications on Lidocaine As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to lidocaine: •
Device for treatment of inflamed tissue Inventor(s): Citow, Jonathan Stuart; (Lake Forest, IL) Correspondence: Russell L. Mci Lwain; Jones, Day, Reavis & Pogue; 77 West Wacker; Chicago; IL; 60601; US Patent Application Number: 20020133110 Date filed: March 16, 2001 Abstract: A double-ended plastic handle is fitted with a cotton swab at each end. Preferably, the swabs are treated with a topical solution of Lidocaine Hydrochloride and each device is wrapped individually in a plastic enclosure. The device may be easily unwrapped and the swabs may be used to conveniently administer the topical solution to affected tissue without requiring any clean-up after discarding the used device. Excerpt(s): Applicant claims priority from U.S. Provisional Application Serial No. 60/262,954, filed Jan. 19, 2001. The present invention relates generally to the medicinal treatment of inflamed tissue and, more particularly to a disposable device for convenient and sanitary topical application of suitable compounds for alleviating the symptoms of hemorrhoid irritation and other anorectal diseases. Many chemical compounds are disclosed in the literature for treatment of inflamed hemorrhoidal tissue and other anorectal diseases. These compounds have the benefit of reducing itching, soreness and other side effects associated with inflamed anorectal tissue. Examples of such compounds include zinc peroxide, as disclosed in U.S. Pat. No. 2,436,673, and urea hydrogen peroxide or benzyl peroxide in combination with hydrocortisone, as disclosed in U.S. Pat. No. 4,514,384, to name a few. Typically, these preparations are provided in
9
This has been a common practice outside the United States prior to December 2000.
122
Lidocaine
the form of suppositories having a semi-solid consistency at room temperature such that they can be wrapped in foil and administered manually. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Heat pipe nerve cooler Inventor(s): Dobak, John D. III; (La Jolla, CA) Correspondence: Mark Wieczorek; Innercool Therapies, INC.; 3931 Sorrento Valley Boulevard; San Diego; CA; 92121; US Patent Application Number: 20020068964 Date filed: January 22, 2002 Abstract: The invention provides a method and apparatus for producing reversible focal hypothermia of the nervous system to control chronic pain. Nerve conduction is blocked by mild cooling (0 to 25.degree. C.), or hypothermia. At these temperatures, nerve tissue is not destroyed and recovers completely when cooling is terminated, such that the treatment is reversible. By blocking conduction in pain nerves, pain sensation is eliminated in a manner analogous to drugs such as lidocaine that also block nerve conduction to provide anesthesia. The invention can be applied to a variety of conditions such as urge incontinence, muscle spasticity, and epilepsy. Many of these disorders are mediated by nerve and nervous tissue that could be interrupted by cooling. In addition, neurologic dysfunction found in multiple sclerosis may improve by cooling of the nerves. The method and apparatus may be used to cool areas of the nervous system affected by multiple sclerosis to allow more normal functions. Excerpt(s): This application is a continuation of co-pending U.S. patent application Ser. No. 09/328,854, filed Jun. 9, 1999, entitled "Heat Pipe Nerve Cooler", which is a continuation-in-part of the following U.S. patent applications: U.S. patent application Ser. No. 09/012,287, filed Jan. 23, 1998, entitled "Selective Organ Hypothermia Method and Apparatus"; U.S. patent application Ser. No. 09/047,012, filed Mar. 24, 1998, entitled "Improved Selective Organ Hypothermia Method and Apparatus"; U.S. patent application Ser. No. 09/052,545, filed Mar. 31, 1998, entitled "Circulating Fluid Hypothermia Method and Apparatus"; U.S. patent application Ser. No. 09/103,342, filed Jun. 23, 1998, entitled "A Selective Organ Cooling Catheter and Method of Using the Same"; U.S. patent application Ser. No. 09/215,038, filed Dec. 16, 1998, entitled "An Inflatable Catheter for Selective Organ Heating and Cooling Catheter and Method of Using the Same"; U.S. patent application Ser. No. 09/215,040, filed Dec. 16, 1998, entitled "Method and Device for Applications of Selective Organ Cooling"; and U.S. patent application Ser. No. 09/262,805, filed Mar. 4, 1999, entitled "A Selective Organ Cooling Catheter with Guide Wire Apparatus", all of which are incorporated herein. Not Applicable. A number of types of nerves are disposed within the posterior gray horn 16. Two types of pain sensing nerves have been identified: A.sub.delta. and C. Referring to FIGS. 2 and 3, A.sub.delta. fibers 18 are disposed within regions I and V and the same produce a rapid initial and intense response to painful stimuli. C fibers 20 are disposed within region II and produce a more blunted but prolonged response. C fibers 20 are believed to be responsible for many chronic pain syndromes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 123
•
High-concentration lidocaine compositions and methods for their preparation Inventor(s): Patel, Pravin M.; (Bloomfield Hills, MI) Correspondence: Gifford, Krass, Groh, Sprinkle; Anderson & Citkowski, PC; 280 N Old Woodard Ave; Suite 400; Birmingham; MI; 48009; US Patent Application Number: 20030104046 Date filed: November 8, 2002 Abstract: A composition comprising lidocaine-containing liposomes wherein the weight concentration of lidocaine in said composition is greater than 10%. The composition is prepared by mixing water with an oil phase comprising lidocaine, a C.sub.14-C.sub.20 alcohol, an alkyl ester of a fatty acid, propylene glycol, and a polyalkyl stearate. The non-aqueous phase may also include a phospholipid such as phosphatidyl choline. Excerpt(s): This invention relates generally to compositions for the topical treatment of skin conditions. More specifically, the invention relates to lidocaine containing compositions. Most specifically, the invention relates to lidocaine containing compositions in which the concentration of lidocaine is over 10% by weight and to methods for manufacturing such compositions. Topical anesthetics such as lidocaine, benzocaine and the like are widely used to treat pain and itching associated with insect bites, sunburn, contact dermatitis, and in connection with anal-rectal conditions such as hemorrhoids, fissures and infections. Most preferably, the topical anesthetic material is disposed in a carrier which is a cream, lotion or gel, and in many instances, liposomal structures are particularly favored carriers. As is known in the art, liposomal structures comprise vesicles having walls formed from a phospholipid or similar material. In general, the efficacy of the anesthetic containing compositions is directly dependent upon the concentration of anesthetic therein. Heretofore, lidocaine containing compositions, particularly those compositions formulated for topical application and/or encapsulated in liposomes, have been restricted to concentrations of approximately 25% lidocaine. Such compositions are shown in U.S. Pat. Nos. 4,937,078 and 6,045,824. Prior to the present invention, the art has not been able to prepare stable lidocaine containing preparations which are suitable for topical application to the skin, and in which the concentration of lidocaine is greater than 10%. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Injectable solution with anti-inflammatory effect and process for manufacturing the same Inventor(s): Ionascu, Elena; (Craiove, RO) Correspondence: Ladas & Parry; 26 West 61st Street; New York; NY; 10023; US Patent Application Number: 20040052872 Date filed: March 28, 2003 Abstract: The present invention relates to an injectable solution with anti-inflammatory effect which has in its composition 1. 700 mg active powder containing water soluble inorganic salts, obtained from the ash resulted by Symphytum officinale roots calcination, in 100 ml distilled water or saline solution, optionally associated with 0.1-0.2 mg Lidocaine for the intramuscular administrating injectable solution. Excerpt(s): The present invention relates to an injectable solution, with antiinflammatory effect, a process for manufacturing the same and a method for the
124
Lidocaine
treatment of autoimmune diseases using the said solution. It is known that an increased number of human diseases, e.g. nephrosis, rheumatoid arthritis, dermatomyositis, chronic hepatitis, leukocytoclastic vasculitis, etc., may be designated as autoimmune disorders. It is generally acknowledged that pathophysiology of immune-complexes, i.e. an autoimmune response following viral, bacterial or parasitic aggression leads to qualitative and quantitative alterations in leukocytes named lymphocytes which are involved in the organism immune defense. An important role in restoring the immune response was proved to be played by drugs with immuno-modulating activity, which, thanks to their composition, rehabilitate the salt balance of the internal human body medium, stimulate the lymphocyte division, promote antibody synthesis and enhance the phagocytic capacity (Franco Dammaco, "Imunologia in Medicina", Edi. Ermes, Milano, 1989, p 67 cap 3.15, tab. 3.2, p 98 tab. 19.8, p 679). Various drugs, which are obtained from medicinal herbs, with active principles having therapeutical qualities for the treatment of immunodeficiency syndrome, are known in the art. Such a product is a composition obtained in the form of a vegetal extract derived from the air segments of the Chimaphila umbellate, Apocynum androsaemifolium, Symphytum officinale and Equisetum hyemale (WO 97-04793). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Medical composition kit for treating lesioned abnormal tissue Inventor(s): Iwamoto, Takako; (Tokyo, JP), Oku, Kinuko; (Naha-shi, JP), Ono, Takashi; (Tokyo, JP) Correspondence: Luke A Kilyk; Kilyk & Bowersox; 53 A East Lee Street; Warrenton; VA; 20186; US Patent Application Number: 20030191070 Date filed: December 31, 2002 Abstract: Optimum compounding composition of a local injection preparation for treating rectal submucous lesioned abnormal tissue with local anesthetic is decided to provide a medical composition kit. In a composition kit for the treatment where respective containers are unsealed upon being used and respective contents are mixed to obtain a preparation for injection, a medical composition kit which is characterized in that respective single doses of a therapeutic preparation and local anesthetic are fractionally charged in containers, the said therapeutic preparation contains 1.about.10% of a water-soluble aluminum compound and 0.01.about.2% of tannic acid and the said local anesthetic contains 0.1.about.1% of lidocaine hydrochloride or 0.5.about.5% of procaine hydrochloride. Excerpt(s): The present invention relates to a medical composition kit of a local injection preparation for treating rectal submucous lesioned abnormal tissue such as hemorrhoid and, more particularly, it relates to a medical composition kit comprising a local injection preparation for treating rectal submucous lesioned abnormal tissue containing a water-soluble aluminum compound and tannic acid and a local anesthetic for treating the same. Treatment of internal hemorrhoid by injection has a history of not shorter than 100 years and, with regard to a composition, a ferric sulfate solution or a solution of phenol in olive oil was used in early years. After that, alcohol, kinin hydrochloride, mercury chloride, urethane, ergot, etc. had been used. In recent 30 years, a solution of phenol in vegetable oil, a solution of alum, etc. have been mainly used. However, those compositions, the following problems for curing the internal hemorrhoid have not been well solved. Thus, in a sclerosing treating method for hemorrhoid by injection
Patents 125
preparations, it is demanded that fibrogenesis of hemorrhoid tissue is finished with stopping the bleeding, inhibiting the growth microbes and remaining no hard nodule or causing no necrosis. However, the injection preparations up to now do not satisfy all of or most of those demands. Further, in injection preparations used in clinic fields, it is difficult to decide appropriate concentration and amount and also to decide a method for sclerosing the internal hemorrhoid without causing necrosis of the tissue. When the above-mentioned composition is injected, the site where the medicament is concentrated is limited to the submucous tissue only and, therefore, the injected site is to be expanded and the administration method is to be improved as well. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus for removing urinary tract stones Inventor(s): Seddon, J. Michael; (Dunn, NC) Correspondence: Coats & Bennett, Pllc; P O Box 5; Raleigh; NC; 27602; US Patent Application Number: 20040153095 Date filed: January 31, 2003 Abstract: A method and apparatus for treating kidney stones in the urinary tract uses a surgical assembly to remove kidney stones. The surgical assembly is inserted into the urinary tract along a guide wire positioned in the surgical assembly. Fluid, such as lidocaine gel and contrast solution, and a stone-removing device enter the urinary tract via channels located in the surgical assembly. Once the surgical assembly is proximate the stone, the physician engages and retains the stone with the stone-removing device. An exemplary stone-removing device includes an expandable spacer and an adjustable stone retainer. When in an expanded position, the spacer engages a portion of the urinary tract. The stone retainer, confined within the expanded spacer, engages and retains the stone while the spacer spaces the urinary tract from the stone retainer. The stone is removed by removing the surgical assembly containing the stone from the urinary tract. Excerpt(s): The present invention generally relates to a method and apparatus for treating stones in the urinary tract of a patient, and more particularly to a method and apparatus for capturing and retaining a urinary tract stone while removing the stone from the urinary tract. The urinary tract, comprising the kidneys, ureters, bladder, and urethra, functions to remove waste and extra water from the body. Kidneys, beanshaped organs approximately the size of a fist, sift waste and extra water from the blood stream. The waste and extra water becomes urine, which flows through the ureters and into the bladder, where it is stored. Once the bladder becomes full, the urine exits the body via the urethra. Normally, the urine contains chemicals to prevent crystalline build-up within the kidneys. However, sometimes these chemicals are either ineffective or absent from the urine. In these instances, crystalline build-up may occur within the kidneys, forming urinary tract stones. Often such stones exit the body unnoticed. However, if a stone becomes large, it may have difficulty passing through the ureters or the urethra and cause great pain to the individual and/or possible damage to the urinary tract. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
126
•
Lidocaine
Method and apparatus for skin absorption enhancement and transdermal drug delivery of lidocaine and/or other drugs Inventor(s): Bernabei, Gian Franco; (Florence, IT) Correspondence: Foley And Lardner; Suite 500; 3000 K Street NW; Washington; DC; 20007; US Patent Application Number: 20040015190 Date filed: May 30, 2003 Abstract: A treatment method for delivery of lidocaine or other type of skin treatment drug to a patient's skin, includes applying electrical bursts of pulses onto the patient's skin by way of electrodes provided on a head of a probe that is placed against the patient's skin. The treatment method also includes applying mechanical vibrations of a same frequency and phase as the bursts of pulses onto the patient's skin by way of a vibrating element provided on the head of the probe. At the same time as the above two steps are being performed, the treatment method includes providing, between the electrodes and the patient's skin, at least two solution-absorbing pads electrically insulated from each other and each one of the two solution-absorbing pads being in electrical contact with one or more of the electrodes on the head of the probe. At least one of the two solution-absorbing pads is soaked with lidocaine or other type of skin treatment drug and the other of the two solution-absorbing pads is soaked with a conductive fisiological solution. The pads may be gauze pads or hydrogel pads. Excerpt(s): This application claims priority to U.S. Provisional Application 60/281,808, filed Apr. 6, 2001, and whereby this application is a continuation-in-part of U.S. patent application Ser. No. 10/397,533, filed Mar. 27, 2003, which in turn is a continuation-inpart of U.S. patent application Ser. No. 10/201,644, filed Jul. 24, 2002, which in turn is a continuation-in-part of U.S. patent application Ser. No. 10/074,234, filed Feb. 14, 2002, which in turn is a continuation-in-part of U.S. patent application Ser. No. 09/942,044, filed Aug. 30, 2001, which in turn is a continuation-in-part of U.S. patent application Ser. No. 09/922,927, filed Aug. 7, 2001, each of which is incorporated in its entirety herein by reference. The invention relates to application of electrical pulses and mechanical vibrations to the skin in a controlled manner, in order to increase the absorption of a substance that is applied at the same time to the skin, whereby the substance is an ascorbic acid, lidocaine, collagen, or other type of skin treatment substance. It is known that an electrical pulse applied to the skin is useful in order to increase the absorption of a substance previously applied to the skin, whereby this technique is known as electroporation. Such a substance to be applied to the skin may be a liquid, a gel, a lotion, or a cream, for example. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Method and kit for treating lower bowel pain Inventor(s): Price, Donald; (Gainesville, FL), Sen, Arup; (Gainesville, FL), Verne, G. Nicholas; (Gainesville, FL) Correspondence: Martin L. Mcgregor; Mcgregor & Associates; 26415 Oak Ridge Drive; Spring; TX; 77380; US Patent Application Number: 20040142968 Date filed: January 17, 2003
Patents 127
Abstract: Lower bowel pain such as that associated with menses, premenstrual syndrome (PMS) or irritable bowel syndrome is alleviated in a mammal suffering therefrom by administering to the mammal a pain alleviating amount of nontoxic local anesthetic such as lidocaine, lidocaine hydrochloride, bupivicaine, and the like. These local anesthetics will be applied as an injected intra rectal jelly, intra rectal suppository, or orally in capsule form. Excerpt(s): The invention is relevant to the field of pain management in a patient and specifically to the treatment of lower bowel pain especially pain associated with menses, premenstrual syndrome (PMS), irritable bowel syndrome (IBS) and other conditions. This invention relates to methods for the specific treatment of pain that arises from nerve impulses from the colon or rectum and especially such pain associated with PMS, IBS and other functional bowel disorders in which there is chronic lower abdominal pain. An example is that of bowel pain associated with menses or pre-menses. Exclusions to this use include intra-rectal local anesthetics during conditions where there exists suspected or demonstrated organic pathology, such as appendicitis. The applicants are not aware of any patents disclosing treatment of lower bowel pain associated with chronic non-pathological conditions by administration of a formulation of a local anesthetic that has not been subjected to conditions that lead to the formation of a complex of the anesthetic with a component of the formulation. The use of local anesthetics, preferably lidocaine, to treat ulcerative proctitis and colitis is disclosed in Ahlman et al., U.S. Pat. No. 5,331,013. In contrast to irritable bowel syndrome, the ulcerative conditions exhibit distinct lesions and may require surgical intervention if not successfully treated by non-invasive means. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method for treating non-neuropathic pain Inventor(s): Galer, Bradley Stuart; (West Chester, PA) Correspondence: IP Department; Schnader Harrison Segal & Lewis; 36th Floor; 1600 Market Street; Philadelphia; PA; 19103; US Patent Application Number: 20030124174 Date filed: October 25, 2001 Abstract: A method including topically administering an effective amount of local anesthetic to a patient is disclosed. The method is effective for inducing analgesia for treating non-neuropathic pain. Non-neuropathic pain suitable for treatment according to the invention includes pain associated with sports injuries; sprains; strains; soft-tissue injury; repetitive motion injury; carpal tunnel syndrome; injury to tendons, ligament, and muscles; conditions such as fibromyalgia, bursitis, castrochondritis, myofascial pain, and pain associated with arthritis, inflammation, contusions, post-surgical pain, and nociceptive pain. Preferably, the lidocaine is applied via a transdermal patch applied near the locus of pain. Excerpt(s): The invention relates to methods of treating non-neuropathic pain. Specifically, the invention relates to methods of treating non-neuropathic pain by topically administering a local anesthetic, such as lidocaine, in an effective amount near the pain location. Most specifically, the invention relates to methods of treating nonneuropathic pain by administering a topical lidocaine patch to a patient, where the transdermal drug delivery results in no clinically meaningful serum drug levels nor produces anesthesia at the site of delivery, i.e. analgesia without anesthesia. Pain can be
128
Lidocaine
treated with either analgesics or anesthetics. A distinguishing feature of analgesics is that they reduce the perception of pain without causing numbness or complete loss of sensation associated with anesthetics. Because of this classification, and the known drugs and their mechanisms of action, it is surprising to learn that a product, traditionally classified as an anesthetic, is useful as a general analgesic. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Methods and compositions for topical wound treatment Inventor(s): Tippett, Aletha; (Cincinnati, OH) Correspondence: Dinsmore & Shohl, Llp; 1900 Chemed Center; 255 East Fifth Street; Cincinnati; OH; 45202; US Patent Application Number: 20040076671 Date filed: February 14, 2003 Abstract: Compositions for improved treatment of wounds on a patient. A first composition having a safe and effective amount of lidocaine, wherein the composition is topically applied to a wound on a patient. A second composition having a safe and effective amount of lidocaine and a safe and effective amount of topical antibiotic, wherein the composition is topically applied to a wound on a patient. A method for treating a patient having a skin wound by locally administering a safe and effective amount of lidocaine and an antibiotic compound in the skin wound such that healing of the skin wound is enhanced. Excerpt(s): The present application claims priority under 35 U.S.C.sctn. 19 of U.S. Provisional Application Serial No. 60/420008 filed Oct. 21, 2002. The present invention relates generally to methods and compositions for treating patients, and more particularly to a method and composition for topical wound treatment. Wounds are commonplace from childhood to old age. Wounds are a significant problem among the geriatric and nursing home population, especially at the end of life. Pressure ulcers alone exact a -tremendous human and financial toll, costing on average more than $1,200 per patient per month to treat. The prevalence of pressure ulcers in 1997 was 16 of every 1,000 nursing home residents. A goal of a federal program, "Healthy People 2010" is a reduction of pressure ulcers to a prevalence of less than 8 per 1,000. Diabetic ulcers similarly result in significant morbidity and costs, with diabetics accounting for approximately 82,000 amputations annually in the U.S., averaging $30,000 per amputation. Other wounds plaguing the nursing home and end of life population are ulcers resulting from arterial and venous insufficiency, as well as traumatic wounds, and non-healing surgical wounds. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Pharmaceutical preparation for apthous ulcers Inventor(s): Arsenault, Peter; (Dracut, MA) Correspondence: Joseph E. Funk; PO Box 661; Londonderry; NH; 03053; US Patent Application Number: 20030114534 Date filed: December 17, 2001
Patents 129
Abstract: The present invention relates to a pharmaceutical preparation for treating apthous ulcers in the human mouth, by rinsing vigorously with a pharmaceutical rinse having a composition comprising ethyl alcohol in a concentration in the order of 50% weight per unit volume and lidocaine in a concentration in the order of 1.0-2.0% weight per unit volume at a periodicity of at least 3 to 4 times daily for thirty seconds each time, followed by expectoration; or by applying the preparation in the form of a lozenge or gel directly to the apthous ulcers. Excerpt(s): The present invention relates to a new pharmaceutical preparation for the treatment of apthous ulcers. An apthous ulcer is a painful oral ulcer, which exists in connection with a disease known as apthous stomatitis and is one of the most common soft tissue diseases seen by dentists. Apthous ulcers occur in the oral cavity in small groups or singularly. Although there has been a great deal of research on the problem of these ulcers, their cause is essentially unknown, and truly effective treatment for curing same and/or relieving the discomfort of same has not been established until conception of the present invention. An apthous ulcer is a recurrent, painful superficial oral ulcer that persists from 10 to 14 days. Apthous ulcers generally affect about 30% of the population. The lesions associated with apthous ulcers are known technically as recurrent apthous stomotitis (RAS) or apthous ulcers. RAS may be "minor" or of a more serious "major" variant. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Pharmaceutically acceptable salts containing local anesthetic and anti-inflammatory activities and methods for preparing the same Inventor(s): Chen, Bin-Ken; (Taichung, TW), Chen, Shan-Chiung; (Fengyuan City, TW), Lee, Fang-Yu; (Taichung, TW), Tsai, Chiung-Ju; (Miaoli, TW), Yi, Yen-Ling; (Taichung, TW) Correspondence: Venable, Baetjer, Howard And Civiletti, Llp; P.O. Box 34385; Washington; DC; 20043-9998; US Patent Application Number: 20040068007 Date filed: October 2, 2002 Abstract: The present invention provides pharmaceutically acceptable salts having local anesthetic and anti-inflammatory activities. The preferred pharmaceutically acceptable salt is a diclofenac salt of lidocaine. Diclofenac is a non-steroidal anti-inflammatory drug ("NSAID"). Lidocaine is a local anesthetic. Other NSAID (except the salicylic acid derivatives of NSAID) can be used to replace diclofenac and/or other local anesthetics can be used to replace lidocaine. The pharmaceutically acceptable salts are crystalline compounds, which are distinctively different from either the NSAID alone or the local anesthetic alone, as indicated by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), High Performance Liquid Chromatography (HPLC) and Fourier-Transformed Infrared Spectroscopy (FTIR) analyses. These pharmaceutically acceptable salts are suitable for use in topical treatment or parenteral injection to treat patients with localized pain, including muscle pain, joint pain, pain associated with herpes infection, and wound pain (such as surgical wound, burn wound etc.). Excerpt(s): The present invention relates to a group of novel pharmaceutically acceptable salts, each containing local anesthetic and anti-inflammatory activities. The preferred pharmaceutical acceptable salt in this group is diclofenac salt of lidocaine.
130
Lidocaine
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). Lidocaine is a local anesthetic. Other NSAID (except the salicylic acid derivatives of NSAID) can be used to replace diclofenac and/or other local anesthetics can be used to replace lidocaine. The pharmaceutically acceptable salts of the present invention are physically and chemically different from either the NSAID alone or the local anesthetic alone. The pharmaceutically acceptable salts of the present invention are particularly suitable for use in topical treatment or parenteral injection to treat patients with localized pain, including, but not limited to, muscle pain, joint pain, pain associated with herpes infection, and/or wound pain (such as surgical pain or burn pain). The present invention also relates to methods for making the pharmaceutically acceptable salts. In the management of pain and discomfort, two kinds of drugs are widely used. The first kind is local anesthetics. Local anesthetics reversibly block the impulse conduction along nerves and other excitable membranes that primarily utilize sodium channels. Clinically, this action blocks the pain sensation from specific areas of the body. Local anesthetics are weak bases. There are three major classes of local anesthetics, which are ester derivatives (such as cocaine, procaine etc.), amide derivatives (such as lidocaine, bupivacaine etc.), and others (such as dyclonine, pramoxine etc.). For therapeutic application, local anesthetics are usually made available as salts for reasons of solubility and stability. In the body, they exist either as the uncharged base (i.e., "free base") or as a cation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with lidocaine, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “lidocaine” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on lidocaine. You can also use this procedure to view pending patent applications concerning lidocaine. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
131
CHAPTER 6. BOOKS ON LIDOCAINE Overview This chapter provides bibliographic book references relating to lidocaine. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on lidocaine include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “lidocaine” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “lidocaine” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “lidocaine” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Effects of lidocaine injections into the lateral parabrachial nucleus on dipsogenic and pressor responses to central angiotensin II in rats short communication (SuDoc NAS 1.26:201817) by Jose Vanderlei Menani; ISBN: B00010XCRC; http://www.amazon.com/exec/obidos/ASIN/B00010XCRC/icongroupinterna
Chapters on Lidocaine In order to find chapters that specifically relate to lidocaine, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and lidocaine using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “lidocaine” (or
132
Lidocaine
synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on lidocaine: •
Hiccups: Reasons and Remedies Source: in Lewis, J.H., ed. Pharmacologic Approach to Gastrointestinal Disorders. Baltimore, MD: Williams and Wilkins. 1994. p. 209-227. Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (800) 638-0672 or (410) 528-4000. Fax (410) 528-4414. PRICE: $85 (as of 1995). ISBN: 0683049704. Summary: In this chapter, from a book on the pharmacologic approach to gastrointestinal disorders, the author explains the pathophysiology of hiccups. The author describes nonpharmacologic treatments first because most individuals attempt a physical or mechanical maneuver to stop hiccups before drug therapy. Specific topics include hiccup frequency; conditions associated with hiccups; hiccups due to anesthesia and surgery; hiccup epidemics; gastrointestinal causes of hiccups; historical cures; the physical and mechanical means of treating hiccups; and drug therapy for hiccups, including the use of major tranquilizers, anticonvulsants, central nervous system stimulants, sedatives, hypnotics, muscle relaxants or antispasticity agents, narcotic analgesics, tricyclic antidepressants, calcium channel blocking agents, dopamine antagonists, dopamine agonists, parasympathomimetics, serotonin antagonists, and lidocaine; and guidelines for treating transient and persistent hiccups. 5 tables. 126 references.
•
Local Drug Delivery Systems for the Treatment of Tinnitus: Principles, Surgical Techniques and Results Source: in Hazell, J., ed. Proceedings of the Sixth International Tinnitus Seminar. London, England: Tinnitus and Hyperacusis Centre. 1999. p. 73-75. Contact: Available from Tinnitus and Hyperacusis Centre. 32 Devonshire Place, London, W1N 1PE, United Kingdom. Fax 44 + (0) 207 486 2218. E-mail:
[email protected]. Website: www.tinnitus.org. PRICE: Contact publisher for price. ISBN: 0953695700. Also available on CD-ROM. Summary: Local treatment of inner ear diseases involves the direct application of pharmacological substances and or electrical stimulation of the inner ear structures. This article on local drug delivery systems for the treatment of tinnitus is from a lengthy document that reprints the proceedings of the Sixth International Tinnitus Seminar, held in Cambridge, United Kingdom, in September 1999 and hosted by the British Society of Audiology. In this article, the authors note that, in contrast to systemic pharmacotherapy, these local delivery systems present no dosage problems, result in no systemic side effects, and bypass the blood cochlea barrier. The round window membrane is the preferred access. The basic precondition is a stable coupling element, which allows a controlled drug release into the perilymphatic space. While technical difficulties do not allow direct access to the perilymphatic space, a catheter possessing a certain shape may be inserted into the round window niche. Among the disadvantages of these local drug delivery systems are the necessity of a surgical procedure, local side effects in the inner ear, only short term benefits from treatment, and the lack of coupling elements and implantable microdosage systems. The authors report on their clinical experiences using this type of local drug delivery system with lidocaine, glutamate, glutamic acid, diethylaesther, caroverine, and gentamycin. 8 references.
Books
•
133
Diabetic Foot Source: in Eton, D. Vascular Disease: A Multi-Specialty Approach to Diagnosis and Management. 2nd ed. Georgetown, TX: Landes Bioscience. 1999. p. 506-511. Contact: Available from Landes Bioscience. 810 South Church Street, Georgetown, TX 78626. (512) 863-7762. Fax (512) 863-0081. Website: www.landesbioscience.com. PRICE: $45.00. ISBN: 1570595615. Summary: This chapter begins with a section that provides demographic data on diabetes, foot amputations, and hospitalizations for extremity problems. This is followed by a section on the pathophysiology of diabetic foot ulcers, which occur as a complication of neurologic or vascular pathology. Neuropathic causes of diabetic foot ulcers include sensory loss, motor fiber degeneration, sympathetic nervous system dysfunction, Charcot foot, and malperforans ulcer. Ischemia results from arterial occlusive disease. The next section focuses on the diagnosis of osteomyelitis. This bone infection often leads to amputation in people who have diabetes. Diagnosis is made using laboratory tests and imaging studies. The fourth section discusses the evaluation of the ischemic ulcer, focusing on the ulcer examination, the vascular examination, xrays, and predictors of healing. This is followed by a section that explains how to manage diabetic ulcers through wound debridement, amputation, and revascularization. The final section discusses the cause, symptoms, management, and prevention of diabetic peripheral neuropathy. Analgesic and anti-inflammatory agents may provide relief for diabetic peripheral neuropathic pain in some patients. When these agents do not relieved pain, psychotropic drugs, lidocaine, mexiletine, and capsaicin cream can be used. Anticonvulsants should be used only after other agents have been unsuccessful. 1 table.
•
Interstitial Cystitis Source: in Dierich, M. and Froe, F. Overcoming Incontinence: A Straightforward Guide to Your Options. Somerset, NJ: John Wiley and Sons, Inc. 2000. p. 105-109. Contact: Available from John Wiley and Sons, Inc. Distribution Center, 1 Wiley Drive, Somerset, NJ 08875-1272. (800) 225-5945 or (732) 469-4400. Fax (732) 302-2300. E-mail:
[email protected]. Website: www.wiley.com. PRICE: $14.95 plus shipping and handling. ISBN: 0471347957. Summary: This chapter on interstitial cystitis (IC) is from a practical guide that dispels the many myths associated with urinary incontinence, offering readers information about the latest options for treatment, from simple lifestyle changes and exercises to devices, medications, and surgery. The authors emphasize that incontinence can be prevented, is almost always treatable, and is often curable. In this chapter, the authors describe IC, a painful, often debilitating, disease of the bladder. The symptoms are severe frequency, urgency, and pain in the lower abdomen or perineum that are relieved with urination. The authors cover diagnosis, theories about the cause of IC, and treatments. With the finding that the lining of the bladder is damaged in IC comes a drug that is marketed specifically for this disease: Elmiron (pentosan polysulfate). This drug helps bladder surface defense mechanisms to detoxify agents in the urine. Dimethylsulfoxide (DMSO) is also used to treat IC; this medication is placed into the bladder on a weekly basis, usually for 6 to 8 weeks, through a temporary catheter inserted in the bladder at the doctor's office. The other medications that are frequently used are heparin, steroids, and lidocaine. Infrequently, surgery is performed to treat IC. The authors encourage patients with IC to learn as much as they can about their disease and to be patient as they try different treatments to cope with this chronic problem.
134
•
Lidocaine
Laryngoscopy Source: in Jafek, B.W.; Stark, A.K., eds. ENT Secrets: Questions You Will Be Asked On Rounds, In the Clinic, In the OR, On Exams. Philadelphia, PA: Hanley and Belfus. 1996. p. 169-172. Contact: Available from Hanley and Belfus. Medical Publishers, 210 South 13th Street, Philadelphia, PA 19107. (800) 962-1892 or (215) 546-7293; Fax (215) 790-9330; http://www.hanleyandbelfus.com. PRICE: $35.95 plus shipping and handling. ISBN: 1560531592. Summary: This chapter on laryngoscopy is from a book that utilizes a question and answer format to review details of the specialty of otorhinolaryngology (ear, nose and throat, or ENT). Laryngoscopy is used to visualize the larynx or 'voicebox.' Topics discussed include the use of indirect laryngoscopy, indications for direct laryngoscopy, advantages and disadvantages of fiberoptic laryngoscopy, vocal cord biopsies and injections, anesthesia used for manipulation of the larynx, superior laryngeal nerve anesthesia, lidocaine, other endoscopic procedures used to evaluate the larynx, ancillary tests used for the evaluation of laryngeal function, cocaine used as part of laryngoscopy (for vasoconstriction, anesthesia, and to decrease the laryngocardiac reflex), laryngospasms, different types of laryngoscopes, postoperative considerations for direct laryngoscopy, potential complications associated with direct laryngoscopy, and controversies in current laryngoscopic techniques. The chapter focuses on helping readers acquire the vocabulary required to discuss laryngoscopy. 5 references.
•
Tinnitus Source: in Canalis, R.F. and Lambert, P.R., eds. Ear: Comprehensive Otology. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 559-570. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030. Fax (301) 223-2300. Website: www.lww.com. PRICE: $179.00 plus shipping and handling. ISBN: 078171558X. Summary: Tinnitus is a frequently presenting complaint best defined as a noise or sound arising in the head of the affected individual. Although the term most often is applied to buzzing, ringing, or roaring sounds, it also includes pulsatile beats, clicks, and other abnormal noises that may or may not have an ear source. This chapter on tinnitus is from a textbook that offers complete coverage of the field of clinical otology (study of the ear). The book is oriented to serve both the otolaryngology resident as a practical learning tool and the practicing otolaryngologist as an updated reference source of clinical and basic information. Topics include definition; prevalence; pathogenesis; diagnosis; classification; vascular lesions, including physical examination, audiometric and radiographic studies, and treatment; muscular lesions; auditory nerve lesions, including acoustic neuroma and vascular loops; cochlear lesions; pharmacologic factors; middle ear lesions, including patulous (open) Eustachian tube; and general management considerations, including drug therapy, surgery, masking, electrical suppression, miscellaneous treatments, and psychosocial aspects. The authors note that treatment of tinnitus is difficult. Although intravenous lidocaine appears to have transient benefit, no oral pharmacologic agent provides consistent relief. Likewise, the results of surgery (e.g., cochlear nerve section) are unpredictable. However, it is possible to mask a patient's tinnitus by amplifying ambient noise with a hearing noise or by introducing noise with a masking device. 9 figures. 2 tables. 78 references.
135
CHAPTER 7. MULTIMEDIA ON LIDOCAINE Overview In this chapter, we show you how to keep current on multimedia sources of information on lidocaine. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on lidocaine is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “lidocaine” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “lidocaine” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on lidocaine: •
FEES: Fiberoptic Endoscopic Evaluation of Swallowing Source: Tucson, AZ: National Center for Neurogenic Communication Disorders, University of Arizona. 1999. (videocassette). Contact: Available from National Center for Neurogenic Communication Disorders, University of Arizona. P.O. Box 210071, Tucson, AZ 85721-0071. (520) 621-1472. Fax (520) 621-2226. PRICE: $25.00 plus shipping and handling. Order Number TR-51. Summary: This videotape program, which is part of the Telerounds videoconference series from the National Center for Neurogenic Communication Disorders at the University of Arizona (funded partly by NIDCD), introduces the viewer to the technique of fiberoptic endoscopic evaluation of swallowing (FEES). This procedure is a comprehensive diagnostic and management tool. The speaker begins with a description of the development of FEES. This is followed by a presentation of the objectives of FEES, including diagnosing suspected dysphagia, determining the nature of the problem, and determining whether any dietary or behavioral interventions can alleviate the problem.
136
Lidocaine
The speaker then identifies the equipment and supplies needed for FEES. Equipment includes a flexible laryngoscope, a light source, a camera, a VCR, a monitor, a video timer, and a cart. Supplies include food or liquid, food color, ice chips, containers or utensils, lidocaine, a high level disinfectant and enzymatic cleaner, and lubricating gel. The speaker then explains the FEES protocol. Part one of the protocol involves anatomic or physiologic assessment of the nasopharynx, oropharynx, hypopharynx, and larynx. Part two of the protocol involves observing how the patient typically deals with food or liquid. The speaker also compares FEES to fluoroscopy for patient indications, findings, and usefulness in managing patients with dysphagia. Examples of abnormal findings are presented from videotaped studies. The program concludes by answering questions asked by the host and phoned in by the teleconference audience and by providing information about joining Centernet, the online forum operated by the Center.
137
CHAPTER 8. PERIODICALS AND NEWS ON LIDOCAINE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover lidocaine.
News Services and Press Releases One of the simplest ways of tracking press releases on lidocaine is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “lidocaine” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to lidocaine. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “lidocaine” (or synonyms). The following was recently listed in this archive for lidocaine: •
Nebulized lidocaine is safe, effective asthma treatment Source: Reuters Industry Breifing Date: June 08, 2004
•
IV lidocaine promising in fibromyalgia Source: Reuters Industry Breifing Date: April 25, 2002
138
Lidocaine
•
Tubal surface lidocaine reduces pain in laparoscopic sterilization Source: Reuters Medical News Date: April 05, 2002
•
Intrarectal lidocaine gel has no analgesic effect during transrectal prostate biopsy Source: Reuters Industry Breifing Date: December 31, 2001
•
Alkalization improves intravesical lidocaine uptake in the bladder Source: Reuters Medical News Date: July 04, 2001
•
Intranasal lidocaine found ineffective for immediate relief of migraine Source: Reuters Industry Breifing Date: April 26, 2001
•
Topical lidocaine appears promising as treatment for migraine Source: Reuters Industry Breifing Date: March 08, 2001
•
Tinnitus relieved by lidocaine perfusion to inner ear plus IV lidocaine Source: Reuters Medical News Date: May 19, 2000
•
Intrauterine lidocaine effective during endometrial biopsies Source: Reuters Medical News Date: March 02, 2000
•
Systemic lidocaine reduces neuropathic central pain Source: Reuters Medical News Date: February 17, 2000
•
Lidocaine-prilocaine superior to lidocaine alone for circumcision pain Source: Reuters Medical News Date: May 31, 1999
•
Some deaths following tumescent liposuction may be due to lidocaine toxicity Source: Reuters Medical News Date: May 13, 1999
•
Inhaled lidocaine may be inappropriate for asthmatics Source: Reuters Medical News Date: February 26, 1999
•
Electromotive intravesical lidocaine effective for transurethral surgery Source: Reuters Medical News Date: January 25, 1999
•
Inhaled lidocaine well tolerated in moderate asthmatics Source: Reuters Medical News Date: January 14, 1999
•
PowderJect delivery of lidocaine safe, effective Source: Reuters Medical News Date: September 30, 1998
•
Intranasal lidocaine relieves acute migraine, may prevent migraine after aura Source: Reuters Medical News Date: June 26, 1998
Periodicals and News
•
Intravenous Lidocaine Temporarily Relieves Fibromyalgia Pain Source: Reuters Medical News Date: February 05, 1997
•
Procainamide: Better Than Lidocaine For Sustained Monomorphic Ventricular Tachycardia Source: Reuters Medical News Date: July 29, 1996
•
Nebulized Lidocaine Useful For Severe, Chronic Asthma Source: Reuters Medical News Date: April 19, 1996
•
Topical Lidocaine Effective Treatment For Postherpetic Neuralgia Source: Reuters Medical News Date: February 28, 1995
139
The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “lidocaine” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “lidocaine” (or synonyms). If you know the name of a company that is relevant to lidocaine,
140
Lidocaine
you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “lidocaine” (or synonyms).
Academic Periodicals covering Lidocaine Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to lidocaine. In addition to these sources, you can search for articles covering lidocaine that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
141
CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for lidocaine. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with lidocaine. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
142
Lidocaine
following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to lidocaine: Anesthetics •
Dental - U.S. Brands: Anbesol Maximum Strength Gel; Anbesol Maximum Strength Liquid; Anbesol Regular Strength Gel; Anbesol Regular Strength Liquid; Anbesol, Baby; Benzodent; Chloraseptic Lozenges; Chloraseptic Lozenges, Children's; Dentapaine; Dent-Zel-Ite; Hurricaine; Numzident; NumZit Gel; Num-Zit Lotion; Orabase, Baby; Orabase-B with Benzocaine; Orajel Maximum Strength; Orajel Nighttime Formula, Baby; Orajel, Baby; Oratect Gel; Rid-A-Pain; SensoGARD Canker Sore Relief; Spec-T Sore Throat Anesthetic; Sucrets Maximum Strength; Sucrets Regular Strength; Sucrets, Children's; Xylocaine; Xylocaine Viscous; Zilactin-L http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202038.html
•
Parenteral-Local - U.S. Brands: Carbocaine; Carbocaine with Neo-Cobefrin; Chirocaine; Citanest Forte; Citanest Plain; Dalcaine; Dilocaine; Duranest; Duranest-MPF; Isocaine; L-Caine; Lidoject-1; Lidoject-2; Marcaine; Marcaine Spinal; Nesacaine; Nesacaine-MPF; Novocain; Octocaine; Polocaine; PolocaineMPF; Pontocaine; Sensorcaine; Sensorcaine-MPF; Sensorcaine-MPF Spinal; Septocaine; Xylocaine; Xylocaine-MPF; Xylocaine-MPF with Glucose http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202040.html
•
Topical - U.S. Brands: Almay Anti-itch Lotion; Americaine Topical Anesthetic First Aid Ointment; Americaine Topical Anesthetic Spray; Butesin Picrate; DermaFlex; Dermoplast; Lagol; Nupercainal Cream; Nupercainal Ointment; Pontocaine Cream; Pontocaine Ointment; Pramegel; Prax; Tronothane; Xylocaine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202042.html
Lidocaine •
Topical - U.S. Brands: Lidoderm http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500058.html
Lidocaine and Prilocaine •
Topical - U.S. Brands: EMLA http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203679.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.
Researching Medications
143
PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
145
APPENDICES
147
APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
10
These publications are typically written by one or more of the various NIH Institutes.
148
Lidocaine
•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
•
National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
•
National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
•
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
•
National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
•
National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
•
National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
Physician Resources
149
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.11 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:12 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
11
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 12 See http://www.nlm.nih.gov/databases/databases.html.
150
Lidocaine
•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway13 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “lidocaine” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 21159 101 982 9 355 22606
HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.17 Simply search by “lidocaine” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
13
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
14
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
Physician Resources
151
Coffee Break: Tutorials for Biologists18 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.19 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
18 Adapted 19
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
153
APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on lidocaine can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to lidocaine. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to lidocaine. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “lidocaine”:
154
Lidocaine
Anesthesia http://www.nlm.nih.gov/medlineplus/anesthesia.html Female Sexual Dysfunction http://www.nlm.nih.gov/medlineplus/femalesexualdysfunction.html Interstitial Cystitis http://www.nlm.nih.gov/medlineplus/interstitialcystitis.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html Tooth Disorders http://www.nlm.nih.gov/medlineplus/toothdisorders.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to lidocaine. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
Patient Resources
155
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to lidocaine. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with lidocaine. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about lidocaine. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “lidocaine” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “lidocaine”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “lidocaine” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
156
Lidocaine
The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “lidocaine” (or a synonym) into the search box, and click “Submit Query.”
157
APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
21
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
158
Lidocaine
libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)22: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
22
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
159
•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
160
Lidocaine
•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
161
•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
162
Lidocaine
•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
163
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
165
LIDOCAINE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 4-Aminopyridine: A potassium channel blocker. It is used primarily as a research tool and is helpful in characterizing subtypes of potassium channels. It has been used clinically in Lambert-Eaton syndrome and multiple sclerosis because by blocking potassium channels it prolongs action potentials thereby increasing transmitter release at the neuromuscular junction (and elsewhere). [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Ablation: The removal of an organ by surgery. [NIH] Abrasion: 1. The wearing away of a substance or structure (such as the skin or the teeth) through some unusual or abnormal mechanical process. 2. An area of body surface denuded of skin or mucous membrane by some unusual or abnormal mechanical process. [EU] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Action Potentials: The electric response of a nerve or muscle to its stimulation. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine
166
Lidocaine
derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenaline: A hormone. Also called epinephrine. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adult-Onset Diabetes: Former term for noninsulin-dependent or type II diabetes. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]
Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]
Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring
Dictionary 167
substances. [EU] Air Embolism: Occurs when the lungs over expand to the point that air bubbles are forced through the air sacs of the lungs into the circulatory system. [NIH] Air Sacs: Thin-walled sacs or spaces which function as a part of the respiratory system in birds, fishes, insects, and mammals. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Resistance: Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Albuterol: A racemic mixture with a 1:1 ratio of the r-isomer, levalbuterol, and s-albuterol. It is a short-acting beta 2-adrenergic agonist with its main clinical use in asthma. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkalinization: The process by which a substance becomes an alkali. An alkali is the opposite of an acid. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Aloe: A genus of the family Liliaceae containing anthraquinone glycosides such as aloinemodin or aloe-emodin (emodin). [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH]
168
Lidocaine
Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alum: A type of immune adjuvant (a substance used to help boost the immune response to a vaccine). Also called aluminum sulfate. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amiodarone: An antianginal and antiarrhythmic drug. It increases the duration of ventricular and atrial muscle action by inhibiting Na,K-activated myocardial adenosine triphosphatase. There is a resulting decrease in heart rate and in vascular resistance. [NIH] Amitriptyline: Tricyclic antidepressant with anticholinergic and sedative properties. It appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. Amitriptyline also appears to antaganize cholinergic and alpha-1 adrenergic responses to bioactive amines. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Ammonium Chloride: An acidifying agent that is used as an expectorant and a diuretic. [NIH]
Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase.
Dictionary 169
Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Ampoule: A small glass or plastic container capable of being sealed so as to preserve its contents in a sterile condition; used principally for containing sterile parenteral solutions (American English: ampule). [EU] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH]
170
Lidocaine
Anhydrous: Deprived or destitute of water. [EU] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antianginal: Counteracting angina or anginal conditions. [EU] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH]
Dictionary 171
Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipruritic: Relieving or preventing itching. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipsychotic Agents: Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in schizophrenia, senile dementia, transient psychosis following surgery or myocardial infarction, etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU]
172
Lidocaine
Antiserum: The blood serum obtained from an animal after it has been immunized with a particular antigen. It will contain antibodies which are specific for that antigen as well as antibodies specific for any other antigen with which the animal has previously been immunized. [NIH] Antispasmodics: Medicines that help reduce or stop muscle spasms in the intestines. Examples are dicyclomine (dy-SY-klo-meen) (Bentyl) and atropine (AH-tro-peen) (Donnatal). [NIH] Antitussive: An agent that relieves or prevents cough. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Aqueous: Having to do with water. [NIH] Aqueous humor: Clear, watery fluid that flows between and nourishes the lens and the cornea; secreted by the ciliary processes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthroscopy: Endoscopic examination, therapy and surgery of the joint. [NIH] Arthrosis: A disease of a joint. [EU] Articular: Of or pertaining to a joint. [EU] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is
Dictionary 173
considered an antioxidant. [NIH] Aspartate: A synthetic amino acid. [NIH] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astringent: Causing contraction, usually locally after topical application. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atracurium: A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrioventricular Node: A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Auditory Cortex: Area of the temporal lobe concerned with hearing. [NIH] Auditory nerve: The eight cranial nerve; also called vestibulocochlear nerve or acoustic nerve. [NIH] Aura: A subjective sensation or motor phenomenon that precedes and marks the of a paroxysmal attack, such as an epileptic attack on set. [EU] Auricular: Pertaining to an auricle or to the ear, and, formerly, to an atrium of the heart. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is
174
Lidocaine
digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Avian: A plasmodial infection in birds. [NIH] Axilla: The underarm or armpit. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]
Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Axotomy: Transection or severing of an axon. This type of denervation is used often in experimental studies on neuronal physiology and neuronal death or survival, toward an understanding of nervous system disease. [NIH] Babesiosis: A group of tick-borne diseases of mammals including zoonoses in humans. They are caused by protozoans of the genus babesia, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick ixodes scapularis. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriorhodopsin: A rhodopsin-like protein found in the purple membrane of Halobacterium halobium and other halophilic bacteria. Its molecular weight is 26,000 and it is bound to retinal in a 1:1 ratio. It has photoreactions similar to those observed in rhodopsin and functions as an energy transducer or proton pump. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Baroreflex: A negative feedback system which buffers short-term changes in blood pressure. Increased pressure stretches blood vessels which activates pressoreceptors (baroreceptors) in the vessel walls. The net response of the central nervous system is a reduction of central
Dictionary 175
sympathetic outflow. This reduces blood pressure both by decreasing peripheral vascular resistance and by lowering cardiac output. Because the baroreceptors are tonically active, the baroreflex can compensate rapidly for both increases and decreases in blood pressure. [NIH]
Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzocaine: A surface anesthetic that acts by preventing transmission of impulses along nerve fibers and at nerve endings. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Benzoyl Peroxide: A peroxide derivative that has been used topically for burns and as a dermatologic agent in the treatment of acne and poison ivy. It is used also as a bleach in the food industry. [NIH] Benzyl Alcohol: A colorless liquid with a sharp burning taste and slight odor. It is used as a local anesthetic and to reduce pain associated with lidocaine injection. Also, it is used in the manufacture of other benzyl compounds, as a pharmaceutic aid, and in perfumery and flavoring. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Bioassay: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH]
176
Lidocaine
Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Viscosity: The internal resistance of the blood to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as sickle cell anemia and polycythemia. [NIH] Blood-Aqueous Barrier: The selectively permeable barrier between the capillary bed in the ciliary body and the aqueous humor. It consists of two layers of epithelium joined at their apical surfaces by tight junctions. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral
Dictionary 177
capillaries and the brain tissue. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]
Body Fluids: Liquid components of living organisms. [NIH] Bone Cements: Adhesives used to fix prosthetic devices to bones and to cement bone to bone in difficult fractures. Synthetic resins are commonly used as cements. A mixture of monocalcium phosphate, monohydrate, alpha-tricalcium phosphate, and calcium carbonate with a sodium phosphate solution is also a useful bone paste. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Artery: The continuation of the axillary artery; it branches into the radial and ulnar arteries. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchiseptica: A small, gram-negative, motile bacillus. A normal inhabitant of the respiratory tract in man, dogs, and pigs, but is also associated with canine infectious tracheobronchitis and atrophic rhinitis in pigs. [NIH] Bronchoconstriction: Diminution of the caliber of a bronchus physiologically or as a result of pharmacological intervention. [NIH] Bronchodilator: A drug that relaxes the smooth muscles in the constricted airway. [NIH] Bronchopulmonary: Pertaining to the lungs and their air passages; both bronchial and pulmonary. [EU] Bronchoscopy: Endoscopic examination, therapy or surgery of the bronchi. [NIH]
178
Lidocaine
Bronchus: A large air passage that leads from the trachea (windpipe) to the lung. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]
Bupivacaine: A widely used local anesthetic agent. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caesarean section: A surgical incision through the abdominal and uterine walls in order to deliver a baby. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Camphor: A bicyclic monoterpene ketone found widely in plant (primarily the camphor tree, Cinnamomum camphora). Natural camphor is used topically as a skin antipruritic and as an anti-infective agent. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU]
Dictionary 179
Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiotoxic: Having a poisonous or deleterious effect upon the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carotid Body: A small cluster of chemoreceptive and supporting cells located near the bifurcation of the internal carotid artery. The carotid body, which is richly supplied with fenestrated capillaries, senses the pH, carbon dioxide, and oxygen concentrations in the blood and plays a crucial role in their homeostatic control. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Caspase: Enzyme released by the cell at a crucial stage in apoptosis in order to shred all cellular proteins. [NIH]
180
Lidocaine
Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Ceftriaxone: Broad-spectrum cephalosporin antibiotic with a very long half-life and high penetrability to usually inaccessible infections, including those involving the meninges, eyes, inner ears, and urinary tract. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary
Dictionary 181
process. [NIH] Central Nervous System Stimulants: A loosely defined group of drugs that tend to increase behavioral alertness, agitation, or excitation. They work by a variety of mechanisms, but usually not by direct excitation of neurons. The many drugs that have such actions as side effects to their main therapeutic use are not included here. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervical Plexus: A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoembolization: A procedure in which the blood supply to the tumor is blocked surgically or mechanically, and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of
182
Lidocaine
infection or insult. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chimeras: Organism that contains a mixture of genetically different cells. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Cholinesterase Inhibitors: Drugs that inhibit cholinesterases. The neurotransmitter acetylcholine is rapidly hydrolyzed, and thereby inactivated, by cholinesterases. When cholinesterases are inhibited, the action of endogenously released acetylcholine at cholinergic synapses is potentiated. Cholinesterase inhibitors are widely used clinically for their potentiation of cholinergic inputs to the gastrointestinal tract and urinary bladder, the eye, and skeletal muscles; they are also used for their effects on the heart and the central nervous system. [NIH] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary Body: A ring of tissue extending from the scleral spur to the ora serrata of the retina. It consists of the uveal portion and the epithelial portion. The ciliary muscle is in the uveal portion and the ciliary processes are in the epithelial portion. [NIH] Cinchona: A genus of rubiaceous South American trees that yields the toxic cinchona alkaloids from their bark; quinine, quinidine, chinconine, cinchonidine and others are used to treat malaria and cardiac arrhythmias. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH]
Dictionary 183
Circumcision: Excision of the prepuce or part of it. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cochlear Nerve: The cochlear part of the 8th cranial nerve (vestibulocochlear nerve). The cochlear nerve fibers originate from neurons of the spiral ganglion and project peripherally to cochlear hair cells and centrally to the cochlear nuclei (cochlear nucleus) of the brain stem. They mediate the sense of hearing. [NIH] Cochlear Nucleus: The brain stem nucleus that receives the central input from the cochlear nerve. The cochlear nucleus is located lateral and dorsolateral to the inferior cerebellar peduncles and is functionally divided into dorsal and ventral parts. It is tonotopically organized, performs the first stage of central auditory processing, and projects (directly or indirectly) to higher auditory areas including the superior olivary nuclei, the medial geniculi, the inferior colliculi, and the auditory cortex. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a
184
Lidocaine
water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive language disorders, cognitive dysfunction (e.g., mental retardation), psychiatric conditions, and hearing disorders. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU]
Dictionary 185
Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH]
186
Lidocaine
Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constrict: Tighten; narrow. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Consummatory Behavior: An act which constitutes the termination of a given instinctive behavior pattern or sequence. [NIH] Contact dermatitis: Inflammation of the skin with varying degrees of erythema, edema and vesinculation resulting from cutaneous contact with a foreign substance or other exposure. [NIH]
Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Contusions: Injuries resulting in hemorrhage, usually manifested in the skin. [NIH] Convalescence: The period of recovery following an illness. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corneal Stroma: The lamellated connective tissue constituting the thickest layer of the cornea between the Bowman and Descemet membranes. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Striatum: Striped gray and white matter consisting of the neostriatum and paleostriatum (globus pallidus). It is located in front of and lateral to the thalamus in each cerebral hemisphere. The gray substance is made up of the caudate nucleus and the
Dictionary 187
lentiform nucleus (the latter consisting of the globus pallidus and putamen). The white matter is the internal capsule. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortices: The outer layer of an organ; used especially of the cerebrum and cerebellum. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Cribriform: Pierced with small holes as in a sieve. Refers to the appearance of a tumor when viewed under a microscope. The tumor appears to have open spaces or small holes inside. [NIH]
Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]
Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]
Cystitis: Inflammation of the urinary bladder. [EU] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior
188
Lidocaine
of genes and chromosomes during cell division. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Dacryocystorhinostomy: Surgical fistulization of the lacrimal sac for external drainage of an obstructed nasolacrimal duct. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Decubitus: An act of lying down; also the position assumed in lying down. [EU] Decubitus Ulcer: An ulceration caused by prolonged pressure in patients permitted to lie too still for a long period of time. The bony prominences of the body are the most frequently affected sites. The ulcer is caused by ischemia of the underlying structures of the skin, fat, and muscles as a result of the sustained and constant pressure. [NIH] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline
Dictionary 189
is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dexmedetomidine: A selective inhibitor of receptors, adrenergic alpha-2 that has analgesic and sedative properties. Medetomidine is the other racemic form. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Dextromethorphan: The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is a NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is used widely as an antitussive agent, and
190
Lidocaine
is also used to study the involvement of glutamate receptors in neurotoxicity. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Foot: Ulcers of the foot as a complication of diabetes. Diabetic foot, often with infection, is a common serious complication of diabetes and may require hospitalization and disfiguring surgery. The foot ulcers are probably secondary to neuropathies and vascular problems. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt, diclofenac sodium. [NIH] Diclofenac Sodium: The sodium form of diclofenac. It is used for its analgesic and antiinflammatory properties. [NIH] Dicyclomine: A muscarinic antagonist used as an antispasmodic and in urinary incontinence. It has little effect on glandular secretion or the cardiovascular system. It does have some local anesthetic properties and is used in gastrointestinal, biliary, and urinary tract spasms. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilator: A device used to stretch or enlarge an opening. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Diphtheria: A localized infection of mucous membranes or skin caused by toxigenic strains of Corynebacterium diphtheriae. It is characterized by the presence of a pseudomembrane at the site of infection. Diphtheria toxin, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH]
Dictionary 191
Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disopyramide: Alpha-(2-(Bis(l-methylethyl)amino)ethyl)-alpha-phenyl-2-pyridine acetamide. A class I anti-arrhythmic agent (one that interferes directly with the depolarization of the cardiac membrane and thus serves as a membrane-stabilizing agent) with a depressant action on the heart similar to that of guanidine. It also possesses some anticholinergic and local anesthetic properties. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dopamine Agonists: Drugs that bind to and activate dopamine receptors. [NIH] Dopamine Antagonists: Drugs that bind to but do not activate dopamine receptors, thereby blocking the actions of dopamine or exogenous agonists. Many drugs used in the treatment of psychotic disorders (antipsychotic agents) are dopamine antagonists, although their therapeutic effects may be due to long-term adjustments of the brain rather than to the acute effects of blocking dopamine receptors. Dopamine antagonists have been used for several other clinical purposes including as antiemetics, in the treatment of Tourette syndrome, and for hiccup. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH]
192
Lidocaine
Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Delivery Systems: Systems of administering drugs through controlled delivery so that an optimum amount reaches the target site. Drug delivery systems encompass the carrier, route, and target. [NIH] Drug Design: The molecular designing of drugs for specific purposes (such as DNAbinding, enzyme inhibition, anti-cancer efficacy, etc.) based on knowledge of molecular properties such as activity of functional groups, molecular geometry, and electronic structure, and also on information cataloged on analogous molecules. Drug design is generally computer-assisted molecular modeling and does not include pharmacokinetics, dosage analysis, or drug administration analysis. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysmenorrhea: Painful menstruation. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysphonia: Difficulty or pain in speaking; impairment of the voice. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH]
Dictionary 193
Ejaculation: The release of semen through the penis during orgasm. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emodin: Purgative anthraquinone found in several plants, especially Rhamnus frangula. It was formerly used as a laxative, but is now used mainly as tool in toxicity studies. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]
Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH]
194
Lidocaine
Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]
Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Endotracheal intubation: Insertion of an airtube into the windpipe. [NIH] Enhancers: Transcriptional element in the virus genome. [NIH] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidemics: A period of increased prevalence of a particular disease in a population. [NIH]
Dictionary 195
Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Equipment and Supplies: Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and experimental procedures. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Esotropia: A form of ocular misalignment characterized by an excessive convergence of the visual axes, resulting in a "cross-eye" appearance. An example of this condition occurs when paralysis of the lateral rectus muscle causes an abnormal inward deviation of one eye on attempted gaze. [NIH] Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and
196
Lidocaine
distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Ethmoid: An unpaired cranial bone which helps form the medial walls of the orbits and contains the themoidal air cells which drain into the nose. [NIH] Etidocaine: A local anesthetic with rapid onset and long action, similar to bupivacaine. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotropia: A form of ocular misalignment where the visual axes diverge inappropriately. For example, medial rectus muscle weakness may produce this condition as the affected eye will deviate laterally upon attempted forward gaze. An exotropia occurs due to the relatively unopposed force exerted on the eye by the lateral rectus muscle, which pulls the eye in an outward direction. [NIH] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]
Expiration: The act of breathing out, or expelling air from the lungs. [EU] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extrasystole: A premature contraction of the heart that is independent of the normal rhythm
Dictionary 197
and arises in response to an impulse in some part of the heart other than the sinoatrial node; called also premature beat. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Facial: Of or pertaining to the face. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the
198
Lidocaine
chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Flecainide: A potent anti-arrhythmia agent, effective in a wide range of ventricular and atrial arrhythmias and tachycardias. Paradoxically, however, in myocardial infarct patients with either symptomatic or asymptomatic arrhythmia, flecainide exacerbates the arrhythmia and is not recommended for use in these patients. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Fluoroscopy: Production of an image when X-rays strike a fluorescent screen. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Foot Ulcer: Lesion on the surface of the skin of the foot, usually accompanied by inflammation. The lesion may become infected or necrotic and is frequently associated with diabetes or leprosy. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Fulminant Hepatic Failure: Liver failure that occurs suddenly in a previously healthy person. The most common causes of FHF are acute hepatitis, acetaminophen overdose, and liver damage from prescription drugs. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to
Dictionary 199
those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastritis: Inflammation of the stomach. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Techniques: Chromosomal, biochemical, intracellular, and other methods used in the study of genetics. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Geniculate Ganglion: The sensory ganglion of the facial (7th cranial) nerve. The geniculate ganglion cells send central processes to the brain stem and peripheral processes to the taste
200
Lidocaine
buds in the anterior tongue, the soft palate, and the skin of the external auditory meatus and the mastoid process. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestational Age: Age of the conceptus. In humans, this may be assessed by medical history, physical examination, early immunologic pregnancy tests, radiography, ultrasonography, and amniotic fluid analysis. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Globus Pallidus: The representation of the phylogenetically oldest part of the corpus striatum called the paleostriatum. It forms the smaller, more medial part of the lentiform nucleus. [NIH] Glomeruli: Plural of glomerulus. [NIH] Glottis: The vocal apparatus of the larynx, consisting of the true vocal cords (plica vocalis) and the opening between them (rima glottidis). [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU] Goniotomy: A surgical procedure for congenital glaucoma in which a sweeping incision is made in the neshwork at the filtration angle by means of a knife-needle inserted through the opposite limbus and carried across the anterior chamber parallel to the iris. [NIH] Gout:
Hereditary
metabolic
disorder
characterized
by
recurrent
acute
arthritis,
Dictionary 201
hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gp120: 120-kD HIV envelope glycoprotein which is involved in the binding of the virus to its membrane receptor, the CD4 molecule, found on the surface of certain cells in the body. [NIH]
Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Guanidine: A strong organic base existing primarily as guanidium ions at physiological pH. It is found in the urine as a normal product of protein metabolism. It is also used in laboratory research as a protein denaturant. (From Martindale, the Extra Pharmacopoeia, 30th ed and Merck Index, 12th ed) It is also used in the treatment of myasthenia and as a fluorescent probe in HPLC. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology. [NIH] Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Hay Fever: A seasonal variety of allergic rhinitis, marked by acute conjunctivitis with lacrimation and itching, regarded as an allergic condition triggered by specific allergens. [NIH]
Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent
202
Lidocaine
headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Hearing Disorders: Conditions that impair the transmission or perception of auditory impulses and information from the level of the ear to the temporal cortices, including the sensorineural pathways. [NIH] Heart Arrest: Sudden and usually momentary cessation of the heart beat. This sudden cessation may, but not usually, lead to death, sudden, cardiac. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hematopoiesis: The development and formation of various types of blood cells. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodilution: Reduction of blood viscosity usually by the addition of cell free solutions. Used clinically l) in states of impaired microcirculation, 2) for replacement of intraoperative blood loss without homologous blood transfusion, and 3) in cardiopulmonary bypass and hypothermia. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoid: An enlarged or swollen blood vessel, usually located near the anus or the rectum. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH]
Dictionary 203
Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Heterotropia: One in which the angle of squint remains relatively unaltered on conjugate movement of the eyes. [NIH] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Hoarseness: An unnaturally deep or rough quality of voice. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain
204
Lidocaine
hormones). [EU] Hyaluronidase: An enzyme that splits hyaluronic acid and thus lowers the viscosity of the acid and facilitates the spreading of fluids through tissues either advantageously or disadvantageously. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, intracranial hypertension; headache; lethargy; urinary incontinence; and ataxia (and in infants macrocephaly). This condition may be caused by obstruction of cerebrospinal fluid pathways due to neurologic abnormalities, intracranial hemorrhages; central nervous system infections; brain neoplasms; craniocerebral trauma; and other conditions. Impaired resorption of cerebrospinal fluid from the arachnoid villi results in a communicating form of hydrocephalus. Hydrocephalus ex-vacuo refers to ventricular dilation that occurs as a result of brain substance loss from cerebral infarction and other conditions. [NIH] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [NIH] Hydrogel: A network of cross-linked hydrophilic macromolecules used in biomedical applications. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrogenation: Specific method of reduction in which hydrogen is added to a substance by the direct use of gaseous hydrogen. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is
Dictionary 205
being studied. [NIH] Hyperreflexia: Exaggeration of reflexes. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypoglycemic: An orally active drug that produces a fall in blood glucose concentration. [NIH]
Hypopharynx: The portion of the pharynx between the inferior portion of the oropharynx and the larynx. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Hysterosalpingography: Radiography of the uterus and fallopian tubes after the injection of a contrast medium. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Ibotenic Acid: Neurotoxic isoxazole substance found in Amanita muscaria and A. pantherina. It causes motor depression, ataxia, and changes in mood, perceptions and feelings, and is a potent excitatory amino acid agonist. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune adjuvant: A drug that stimulates the immune system to respond to disease. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using
206
Lidocaine
labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppression: Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Incubation period: The period of time likely to elapse between exposure to the agent of the disease and the onset of clinical symptoms. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be
Dictionary 207
clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Instillation: . [EU] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interneurons: Most generally any neurons which are not motor or sensory. Interneurons may also refer to neurons whose axons remain within a particular brain region as contrasted with projection neurons which have axons projecting to other brain regions. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU]
208
Lidocaine
Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravenous: IV. Into a vein. [NIH] Intravenous Anesthetics: The systemic administration of an anesthetic drug via an injection into the vein. [NIH] Intravesical: Within the bladder. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ion Exchange: Reversible chemical reaction between a solid, often an ION exchange resin, and a fluid whereby ions may be exchanged from one substance to another. This technique is used in water purification, in research, and in industry. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iontophoresis: Therapeutic introduction of ions of soluble salts into tissues by means of electric current. In medical literature it is commonly used to indicate the process of increasing the penetration of drugs into surface tissues by the application of electric current. It has nothing to do with ion exchange, air ionization nor phonophoresis, none of which
Dictionary 209
requires current. [NIH] Ipsilateral: Having to do with the same side of the body. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects. [NIH] Isopropyl: A gene mutation inducer. [NIH] Isoproterenol: Isopropyl analog of epinephrine; beta-sympathomimetic that acts on the heart, bronchi, skeletal muscle, alimentary tract, etc. It is used mainly as bronchodilator and heart stimulant. [NIH] Isosorbide: 1,4:3,6-Dianhydro D-glucitol. Chemically inert osmotic diuretic used mainly to treat hydrocephalus; also used in glaucoma. [NIH] Isosorbide Dinitrate: A vasodilator used in the treatment of angina. Its actions are similar to nitroglycerin but with a slower onset of action. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [NIH] Ketorolac: A drug that belongs to a family of drugs called nonsteroidal anti-inflammatory agents. It is being studied in cancer prevention. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH]
210
Lidocaine
Laceration: 1. The act of tearing. 2. A torn, ragged, mangled wound. [EU] Lacrimal: Pertaining to the tears. [EU] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders. [NIH] Lanolin: A yellow fat obtained from sheep's wool. It is used as an emollient, cosmetic, and pharmaceutic aid. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Laryngitis: Inflammation of the larynx. This condition presents itself with dryness and soreness of the throat, difficulty in swallowing, cough, and hoarseness. [NIH] Laryngoscope: A thin, lighted tube used to examine the larynx (voice box). [NIH] Laryngoscopy: Examination, therapy, or surgery of the interior of the larynx performed with a specially designed endoscope. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]
Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH]
Dictionary 211
Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Lingual Nerve: A sensory branch of the mandibular nerve, which is part of the trigeminal (5th cranial) nerve. The lingual nerve carries general afferent fibers from the anterior twothirds of the tongue, the floor of the mouth, and the mandibular gingivae. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipectomy: Removal of localized subcutaneous fat deposits by suction curettage or blunt cannulization in the cosmetic correction of obesity and other esthetic contour defects. [NIH] Lipid: Fat. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]
Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Long-Term Potentiation: A persistent increase in synaptic efficacy, usually induced by appropriate activation of the same synapses. The phenomenological properties of long-term potentiation suggest that it may be a cellular mechanism of learning and memory. [NIH] Lubricants: Oily or slippery substances. [NIH] Lubrication: The application of a substance to diminish friction between two surfaces. It
212
Lidocaine
may refer to oils, greases, and similar substances for the lubrication of medical equipment but it can be used for the application of substances to tissue to reduce friction, such as lotions for skin and vaginal lubricants. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Depletion: Immunosuppression by reduction of circulating lymphocytes or by T-cell depletion of bone marrow. The former may be accomplished in vivo by thoracic duct drainage or administration of antilymphocyte serum. The latter is performed ex vivo on bone marrow before its transplantation. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mandibular Nerve: A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura. [NIH] Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Masticatory: 1. subserving or pertaining to mastication; affecting the muscles of mastication. 2. a remedy to be chewed but not swallowed. [EU] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm
Dictionary 213
and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Menthol: An alcohol produced from mint oils or prepared synthetically. [NIH] Meperidine: 1-Methyl-4-phenyl-4-piperidinecarboxylic acid ethyl ester. A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and
214
Lidocaine
lymphatic tissue. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methacrylate: A vinyl monomer. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methylcellulose: Methylester of cellulose. Methylcellulose is used as an emulsifying and suspending agent in cosmetics, pharmaceutics and the chemical industry. It is used therapeutically as a bulk laxative. [NIH] Mexiletine: Antiarrhythmic agent pharmacologically similar to lidocaine. It may have some anticonvulsant properties. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microspheres: Small uniformly-sized spherical particles frequently radioisotopes or various reagents acting as tags or markers. [NIH]
labeled
with
Midazolam: A short-acting compound, water-soluble at pH less than 4 and lipid-soluble at physiological pH. It is a hypnotic-sedative drug with anxiolytic and amnestic properties. It is used for sedation in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic
Dictionary 215
medication, and as an adjunct to local anesthesia. Because of its short duration and cardiorespiratory stability, it is particularly useful in poor-risk, elderly, and cardiac patients. [NIH]
Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Conformation: The characteristic three-dimensional shape of a molecule. [NIH] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocyte: A type of white blood cell. [NIH] Monocyte Chemoattractant Protein-1: A chemokine that is a chemoattractant for human monocytes and may also cause cellular activation of specific functions related to host defense. It is produced by leukocytes of both monocyte and lymphocyte lineage and by fibroblasts during tissue injury. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH]
216
Lidocaine
Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscimol: Neurotoxic isoxazole isolated from Amanita muscaria and A. phalloides and also obtained by decarboxylation of ibotenic acid. It is a potent agonist at GABA-A receptors and is used mainly as an experimental tool in animal and tissue studies. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle Spasticity: Strongly marked hypertonicity of muscles. [NIH] Muscle Spindles: Mechanoreceptors found between skeletal muscle fibers. Muscle spindles are arranged in parallel with muscle fibers and respond to the passive stretch of the muscle, but cease to discharge if the muscle contracts isotonically, thus signaling muscle length. The muscle spindles are the receptors responsible for the stretch or myotactic reflex. [NIH] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Myalgia: Pain in a muscle or muscles. [EU] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mydriasis: Dilation of pupils to greater than 6 mm combined with failure of the pupils to constrict when stimulated with light. This condition may occur due to injury of the pupillary fibers in the oculomotor nerve, in acute angle-closure glaucoma, and in Adie syndrome. [NIH]
Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelitis: Inflammation of the spinal cord. Relatively common etiologies include infections; autoimmune diseases; spinal cord; and ischemia (see also spinal cord vascular diseases). Clinical features generally include weakness, sensory loss, localized pain, incontinence, and other signs of autonomic dysfunction. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the
Dictionary 217
heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia is a characteristic feature of myotonic disorders. [NIH] Nalbuphine: A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors. [NIH] Naproxen: An anti-inflammatory agent with analgesic and antipyretic properties. Both the acid and its sodium salt are used in the treatment of rheumatoid arthritis and other rheumatic or musculoskeletal disorders, dysmenorrhea, and acute gout. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nasolacrimal: Pertaining to the nose and lacrimal apparatus. [EU] Nasopharynx: The nasal part of the pharynx, lying above the level of the soft palate. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Nearsightedness: The common term for myopia. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Neostigmine: A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike physostigmine, does not cross the blood-brain barrier. [NIH] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH]
218
Lidocaine
Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural Pathways: Neural tracts connecting one part of the nervous system with another. [NIH]
Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]
Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Blocking Agents: Drugs that interrupt transmission of nerve impulses at the skeletal neuromuscular junction. They can be of two types, competitive, stabilizing blockers (neuromuscular nondepolarizing agents) or noncompetitive, depolarizing agents (neuromuscular depolarizing agents). Both prevent acetylcholine from triggering the muscle contraction and they are used as anesthesia adjuvants, as relaxants during electroshock, in convulsive states, etc. [NIH] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH]
Dictionary 219
Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system. [NIH] Neurotoxic: Poisonous or destructive to nerve tissue. [EU] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]
Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neurotrophins: A nerve growth factor. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] Niche: The ultimate unit of the habitat, i. e. the specific spot occupied by an individual organism; by extension, the more or less specialized relationships existing between an organism, individual or synusia(e), and its environment. [NIH] Nictitating Membrane: A fold of the mucous membrane of the conjunctiva in many animals. At rest, it is hidden in the medial canthus. It can extend to cover part or all of the cornea to help clean the cornea. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nitroglycerin: A highly volatile organic nitrate that acts as a dilator of arterial and venous smooth muscle and is used in the treatment of angina. It provides relief through improvement of the balance between myocardial oxygen supply and demand. Although total coronary blood flow is not increased, there is redistribution of blood flow in the heart
220
Lidocaine
when partial occlusion of coronary circulation is effected. [NIH] Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream. [NIH]
Nociceptors: Peripheral receptors for pain. Nociceptors include receptors which are sensitive to painful mechanical stimuli, extreme heat or cold, and chemical stimuli. All nociceptors are free nerve endings. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oculomotor: Cranial nerve III. It originate from the lower ventral surface of the midbrain and is classified as a motor nerve. [NIH] Oculomotor Nerve: The 3d cranial nerve. The oculomotor nerve sends motor fibers to the levator muscles of the eyelid and to the superior rectus, inferior rectus, and inferior oblique muscles of the eye. It also sends parasympathetic efferents (via the ciliary ganglion) to the muscles controlling pupillary constriction and accommodation. The motor fibers originate in the oculomotor nuclei of the midbrain. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Olfactory Bulb: Ovoid body resting on the cribriform plate of the ethmoid bone where the olfactory nerve terminates. The olfactory bulb contains several types of nerve cells including the mitral cells, on whose dendrites the olfactory nerve synapses, forming the olfactory glomeruli. The accessory olfactory bulb, which receives the projection from the vomeronasal organ via the vomeronasal nerve, is also included here. [NIH] Olfactory Nerve: The 1st cranial nerve. The olfactory nerve conveys the sense of smell. It is
Dictionary 221
formed by the axons of olfactory receptor neurons which project from the olfactory epithelium (in the nasal epithelium) to the olfactory bulb. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic cup: The white, cup-like area in the center of the optic disc. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Oropharynx: Oral part of the pharynx. [NIH] Orthopaedic: Pertaining to the correction of deformities of the musculoskeletal system; pertaining to orthopaedics. [EU] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH]
222
Lidocaine
Otology: The branch of medicine which deals with the diagnosis and treatment of the disorders and diseases of the ear. [NIH] Otorhinolaryngology: That branch of medicine concerned with medical and surgical treatment of the head and neck, including the ears, nose and throat. [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Overactive bladder: A condition in which the patient experiences two or all three of the following conditions: [NIH] Overdosage: 1. The administration of an excessive dose. 2. The condition resulting from an excessive dose. [EU] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Papaverine: An alkaloid found in opium but not closely related to the other opium alkaloids in its structure or pharmacological actions. It is a direct-acting smooth muscle relaxant used in the treatment of impotence and as a vasodilator, especially for cerebral vasodilation. The mechanism of its pharmacological actions is not clear, but it apparently can inhibit phosphodiesterases and it may have direct actions on calcium channels. [NIH]
Dictionary 223
Papilla: A small nipple-shaped elevation. [NIH] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Paradoxical: Occurring at variance with the normal rule. [EU] Paralysis: Loss of ability to move all or part of the body. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parasympathetic Nervous System: The craniosacral division of the autonomic nervous system. The cell bodies of the parasympathetic preganglionic fibers are in brain stem nuclei and in the sacral spinal cord. They synapse in cranial autonomic ganglia or in terminal ganglia near target organs. The parasympathetic nervous system generally acts to conserve resources and restore homeostasis, often with effects reciprocal to the sympathetic nervous system. [NIH] Parasympathomimetics: Drugs that mimic the effects of parasympathetic nervous system activity. Included here are drugs that directly stimulate muscarinic receptors and drugs that potentiate cholinergic activity, usually by slowing the breakdown of acetylcholine (cholinesterase inhibitors). Drugs that stimulate both sympathetic and parasympathetic postganglionic neurons (ganglionic stimulants) are not included here. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Paresthesia: Subjective cutaneous sensations (e.g., cold, warmth, tingling, pressure, etc.) that are experienced spontaneously in the absence of stimulation. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH]
224
Lidocaine
Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Pedicle: Embryonic link between the optic vesicle or optic cup and the forebrain or diencephalon, which becomes the optic nerve. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pentosan polysulfate: A drug used to relieve pain or discomfort associated with chronic inflammation of the bladder. It is also being evaluated for its protective effects on the gastrointestinal tract in people undergoing radiation therapy. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide T: N-(N-(N(2)-(N-(N-(N-(N-D-Alanyl L-seryl)-L-threonyl)-L-threonyl) L-threonyl)L-asparaginyl)-L-tyrosyl) L-threonine. Octapeptide sharing sequence homology with HIV envelope protein gp120. It is potentially useful as antiviral agent in AIDS therapy. The core pentapeptide sequence, TTNYT, consisting of amino acids 4-8 in peptide T, is the HIV envelope sequence required for attachment to the CD4 receptor. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Periodicity: The tendency of a phenomenon to recur at regular intervals; in biological systems, the recurrence of certain activities (including hormonal, cellular, neural) may be annual, seasonal, monthly, daily, or more frequently (ultradian). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]
Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the
Dictionary 225
autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peripheral stem cells: Immature cells found circulating in the bloodstream. New blood cells develop from peripheral stem cells. [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Pertussis: An acute, highly contagious infection of the respiratory tract, most frequently affecting young children, usually caused by Bordetella pertussis; a similar illness has been associated with infection by B. parapertussis and B. bronchiseptica. It is characterized by a catarrhal stage, beginning after an incubation period of about two weeks, with slight fever, sneezing, running at the nose, and a dry cough. In a week or two the paroxysmal stage begins, with the characteristic paroxysmal cough, consisting of a deep inspiration, followed by a series of quick, short coughs, continuing until the air is expelled from the lungs; the close of the paroxysm is marked by a long-drawn, shrill, whooping inspiration, due to spasmodic closure of the glottis. This stage lasts three to four weeks, after which the convalescent stage begins, in which paroxysms grow less frequent and less violent, and finally cease. Called also whooping cough. [EU] Petrolatum: A colloidal system of semisolid hydrocarbons obtained from petroleum. It is used as an ointment base, topical protectant, and lubricant. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Phantom: Used to absorb and/or scatter radiation equivalently to a patient, and hence to
226
Lidocaine
estimate radiation doses and test imaging systems without actually exposing a patient. It may be an anthropomorphic or a physical test object. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharyngeal Muscles: The muscles of the pharynx are the inferior, middle and superior constrictors, salpingopharyngeus, and stylopharyngeus. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenolphthalein: An acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. It is used medicinally as a cathartic. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenoxybenzamine: An alpha-adrenergic anatagonist with long duration of action. It has been used to treat hypertension and as a peripheral vasodilator. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenytoin: An anticonvulsant that is used in a wide variety of seizures. It is also an antiarrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. [NIH] Phobias: An exaggerated and invariably pathological dread of some specific type of stimulus or situation. [NIH] Phonophoresis: Use of ultrasound to increase the percutaneous adsorption of drugs. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and
Dictionary 227
function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Physostigmine: A cholinesterase inhibitor that is rapidly absorbed through membranes. It can be applied topically to the conjunctiva. It also can cross the blood-brain barrier and is used when central nervous system effects are desired, as in the treatment of severe anticholinergic toxicity. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Plant Oils: Oils derived from plants or plant products. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Plastids: Self-replicating cytoplasmic organelles of plant and algal cells that contain pigments and may synthesize and accumulate various substances. Plastids are used in phylogenetic studies. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form.
228
Lidocaine
Also called thrombocytes. [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Podiatry: A specialty concerned with the diagnosis and treatment of foot disorders and injuries and anatomic defects of the foot. [NIH] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]
Polyethylene Glycols: Alpha-Hydro-omega-hydroxypoly(oxy-1,2-ethanediyls). Additional polymers of ethylene oxide and water and their ethers. They vary in consistency from liquid to solid, depending on the molecular weight, indicated by a number following the name. Used as surfactants in industry, including foods, cosmetics and pharmaceutics; in biomedicine, as dispersing agents, solvents, ointment and suppository bases, vehicles, tablet excipients. Some specific groups are lauromagrogols, nonoxynols, octoxynols and poloxamers. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polyneuritis: Inflammation of several peripheral nerves at the same time. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postherpetic Neuralgia: Variety of neuralgia associated with migraine in which pain is felt in or behind the eye. [NIH] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-synaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of
Dictionary 229
muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Channels: Cell membrane glycoproteins selective for potassium ions. [NIH] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH] Pregnancy Tests: Tests to determine whether or not an individual is pregnant. [NIH] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prepuce: A covering fold of skin; often used alone to designate the preputium penis. [EU] Pressoreceptors: Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block.
230
Lidocaine
(From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Proctitis: Inflammation of the rectum. [EU] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Propafenone: An antiarrhythmia agent that is particularly effective in ventricular arrhythmias. It also has weak beta-blocking activity. The drug is generally well tolerated. [NIH]
Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propofol: A widely used anesthetic. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Proprioception: The mechanism involved in the self-regulation of posture and movement through stimuli originating in the receptors imbedded in the joints, tendons, muscles, and labyrinth. [NIH] Propylene Glycol: A clear, colorless, viscous organic solvent and diluent used in pharmaceutical preparations. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the
Dictionary 231
peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Pseudorabies: A highly contagious herpesvirus infection affecting the central nervous system of swine, cattle, dogs, cats, rats, and other animals. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the
232
Lidocaine
international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pupil: The aperture in the iris through which light passes. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Quinidine: An optical isomer of quinine, extracted from the bark of the Cinchona tree and similar plant species. This alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. It prolongs cellular action potential, and decreases automaticity. Quinidine also blocks muscarinic and alphaadrenergic neurotransmission. [NIH] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radial Artery: The direct continuation of the brachial trunk, originating at the bifurcation of the brachial artery opposite the neck of the radius. Its branches may be divided into three groups corresponding to the three regions in which the vessel is situated, the forearm, wrist, and hand. [NIH] Radial Keratotomy: Commonly referred to as RK; a surgical procedure designed to correct myopia (nearsightedness) by flattening the cornea using radial cuts. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH]
Dictionary 233
Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radicular: Having the character of or relating to a radicle or root. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Adrenergic: Cell-surface proteins that bind epinephrine and/or norepinephrine with high affinity and trigger intracellular changes. The two major classes of adrenergic receptors, alpha and beta, were originally discriminated based on their cellular actions but now are distinguished by their relative affinity for characteristic synthetic ligands. Adrenergic receptors may also be classified according to the subtypes of G-proteins with which they bind; this scheme does not respect the alpha-beta distinction. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH]
234
Lidocaine
Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reentry: Reexcitation caused by continuous propagation of the same impulse for one or more cycles. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Resected: Surgical removal of part of an organ. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Reticular: Coarse-fibered, netlike dermis layer. [NIH] Reticular Formation: A region extending from the pons & medulla oblongata through the mesencephalon, characterized by a diversity of neurons of various sizes and shapes, arranged in different aggregations and enmeshed in a complicated fiber network. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines
Dictionary 235
with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrobulbar: Behind the pons. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]
Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Round Window: Fenestra of the cochlea; an opening in the medial wall of the middle ear leading into the cochlea. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Saccades: An abrupt voluntary shift in ocular fixation from one point to another, as occurs in reading. [NIH] Salicylic: A tuberculosis drug. [NIH] Saline: A solution of salt and water. [NIH] Sanitary: Relating or belonging to health and hygiene; conductive to the restoration or maintenance of health. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each
236
Lidocaine
consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Scatter: The extent to which relative success and failure are divergently manifested in qualitatively different tests. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH]
Dictionary 237
Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Sequela: Any lesion or affection following or caused by an attack of disease. [EU] Sequence Homology: The degree of similarity between sequences. Studies of amino acid and nucleotide sequences provide useful information about the genetic relatedness of certain species. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serotonin Agonists: Agents that have an affinity for serotonin receptors and are able to mimic the effects of serotonin by stimulating the physiologic activity at the cell receptors. These compounds are used as antidepressants, anxiolytics, and in the treatment of migraine. [NIH]
Serotonin Antagonists: Drugs that bind to but do not activate serotonin receptors, thereby blocking the actions of serotonin or serotonin agonists. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the
238
Lidocaine
one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sinoatrial Node: The small mass of modified cardiac muscle fibers located at the junction of the superior vena cava and right atrium. Contraction impulses probably start in this node, spread over the atrium and are then transmitted by the atrioventricular bundle to the ventricle. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin Care: Maintenance of the hygienic state of the skin under optimal conditions of cleanliness and comfort. Effective in skin care are proper washing, bathing, cleansing, and the use of soaps, detergents, oils, etc. In various disease states, therapeutic and protective solutions and ointments are useful. The care of the skin is particularly important in various occupations, in exposure to sunlight, in neonates, and in decubitus ulcer. [NIH] Skin graft: Skin that is moved from one part of the body to another. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Social Behavior: Any behavior caused by or affecting another individual, usually of the same species. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH]
Dictionary 239
Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Somatosensory Cortex: Area of the parietal lobe concerned with receiving general sensations. It lies posterior to the central sulcus. [NIH] Sonogram: A computer picture of areas inside the body created by bouncing sound waves off organs and other tissues. Also called ultrasonogram or ultrasound. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spike: The activation of synapses causes changes in the permeability of the dendritic
240
Lidocaine
membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Vascular Diseases: Hypoxic-ischemic and hemorrhagic disorders of the spinal cord. Arteriosclerosis, emboli, and vascular malformations are potential causes of these conditions. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spiral Ganglion: The sensory ganglion of the cochlear nerve. The cells of the spiral ganglion send fibers peripherally to the cochlear hair cells and centrally to the cochlear nuclei of the brain stem. [NIH] Spiral Lamina: The bony plate which extends outwards from the modiolus. It is part of the structure which divides trhe cochlea into sections. [NIH] Stabilization: The creation of a stable state. [EU] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Steady state: Dynamic equilibrium. [EU] Steatosis: Fatty degeneration. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stereotactic: Radiotherapy that treats brain tumors by using a special frame affixed directly to the patient's cranium. By aiming the X-ray source with respect to the rigid frame, technicians can position the beam extremely precisely during each treatment. [NIH] Sterile: Unable to produce children. [NIH] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]
Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strabismus: Deviation of the eye which the patient cannot overcome. The visual axes
Dictionary 241
assume a position relative to each other different from that required by the physiological conditions. The various forms of strabismus are spoken of as tropias, their direction being indicated by the appropriate prefix, as cyclo tropia, esotropia, exotropia, hypertropia, and hypotropia. Called also cast, heterotropia, manifest deviation, and squint. [EU] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Styptic: Astringent. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Submucous: Occurring beneath the mucosa or a mucous membrane. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Succinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for. [NIH]
Sucralfate: A basic aluminum complex of sulfated sucrose. It is advocated in the therapy of peptic, duodenal, and prepyloric ulcers, gastritis, reflux esophagitis, and other gastrointestinal irritations. It acts primarily at the ulcer site, where it has cytoprotective, pepsinostatic, antacid, and bile acid-binding properties. The drug is only slightly absorbed by the digestive mucosa, which explains the absence of systemic effects and toxicity. [NIH]
242
Lidocaine
Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sudden cardiac death: Cardiac arrest caused by an irregular heartbeat. [NIH] Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppository: A medicated mass adapted for introduction into the rectal, vaginal, or urethral orifice of the body, suppository bases are solid at room temperature but melt or dissolve at body temperature. Commonly used bases are cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, polyethylene glycols of various molecular weights, and fatty acid esters of polyethylene glycol. [EU] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supratentorial: Located in the upper part of the brain. [NIH] Supraventricular: Situated or occurring above the ventricles, especially in an atrium or atrioventricular node. [EU] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]
Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of
Dictionary 243
homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Vesicles: Membrane-bound compartments which contain transmitter molecules. Synaptic vesicles are concentrated at presynaptic terminals. They actively sequester transmitter molecules from the cytoplasm. In at least some synapses, transmitter release occurs by fusion of these vesicles with the presynaptic membrane, followed by exocytosis of their contents. [NIH] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Taste Buds: Small sensory organs which contain gustatory receptor cells, basal cells, and supporting cells. Taste buds in humans are found in the epithelia of the tongue, palate, and pharynx. They are innervated by the chorda tympani nerve (a branch of the facial nerve) and the glossopharyngeal nerve. [NIH] Taurine: 2-Aminoethanesulfonic acid. A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids. [NIH] Tea Tree Oil: Essential oil extracted from Melaleuca alternifolia (tea tree). It is used as a topical antimicrobial due to the presence of terpineol. [NIH] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetani: Causal agent of tetanus. [NIH] Tetanic: Having the characteristics of, or relating to tetanus. [NIH] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by Clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [NIH] Tetracaine: A potent local anesthetic of the ester type used for surface and spinal anesthesia.
244
Lidocaine
[NIH]
Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Tetrodotoxin: Octahydro-12-(hydroxymethyl)-2-imino-5,9:7,10a-dimethano10aH(1,3)dioxocino(6,5-a)pyrimidine-4,7,10,11,12-pentol. An aminoperhydroquinazoline poison found mainly in the liver and ovaries of fishes in the order Tetradontiformes (pufferfish, globefish, toadfish), which are eaten. The toxin causes paresthesia and paralysis through interference with neuromuscular conduction. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]
Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosed: A localized clot that either forms in the vein of a hemorrhoid or arises from a ruptured hemorrhoidal blood vessel. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymidine: A chemical compound found in DNA. Also used as treatment for mucositis. [NIH]
Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus
Dictionary 245
refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Tourniquet: A device, band or elastic tube applied temporarily to press upon an artery to stop bleeding; a device to compress a blood vessel in order to stop bleeding. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trabecular Meshwork: A porelike structure surrounding the entire circumference of the anterior chamber through which aqueous humor circulates to the canal of Schlemm. [NIH]
246
Lidocaine
Trabeculectomy: Any surgical procedure for treatment of glaucoma by means of puncture or reshaping of the trabecular meshwork. It includes goniotomy, trabeculotomy, and laser perforation. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Tranquilizing Agents: A traditional grouping of drugs said to have a soothing or calming effect on mood, thought, or behavior. Included here are the anti-anxiety agents (minor tranquilizers), antimanic agents, and the antipsychotic agents (major tranquilizers). These drugs act by different mechanisms and are used for different therapeutic purposes. [NIH] Transcutaneous: Transdermal. [EU] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Transrectal ultrasound: A procedure used to examine the prostate. An instrument is inserted into the rectum, and sound waves bounce off the prostate. These sound waves create echoes, which a computer uses to create a picture called a sonogram. [NIH] Transurethral: Performed through the urethra. [EU] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Triad: Trivalent. [NIH] Triamcinolone Acetonide: An esterified form of triamcinolone. It is an anti-inflammatory glucocorticoid used topically in the treatment of various skin disorders. Intralesional, intramuscular, and intra-articular injections are also administered under certain conditions. [NIH]
Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU]
Dictionary 247
Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trimecaine: Acetanilide derivative used as a local anesthetic. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tubocurarine: A neuromuscular blocker and active ingredient in curare; plant based alkaloid of Menispermaceae. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumorigenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH]
Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]
Tympani: The part of the cochlea below the spiral lamina. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethane: Antineoplastic agent that is also used as a veterinary anesthetic. It has also been used as an intermediate in organic synthesis. Urethane is suspected to be a carcinogen. [NIH]
248
Lidocaine
Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]
Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Valproic Acid: A fatty acid with anticonvulsant properties used in the treatment of epilepsy. The mechanisms of its therapeutic actions are not well understood. It may act by increasing GABA levels in the brain or by altering the properties of voltage dependent sodium channels. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Varicella: Chicken pox. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH]
Dictionary 249
Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous Insufficiency: Inadequacy of the venous valves and impairment of venous return (venous stasis) usually from the legs, often with edema and sometimes with stasis ulcers at the ankle. [NIH] Venter: Belly. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventral Tegmental Area: A region in the mesencephalon which is dorsomedial to the substantia nigra and ventral to the red nucleus. The mesocortical and mesolimbic dopaminergic systems originate here, including an important projection to the nucleus accumbens. Overactivity of the cells in this area has been suspected to contribute to the positive symptoms of schizophrenia. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular fibrillation: Rapid, irregular quivering of the heart's ventricles, with no effective heartbeat. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei
250
Lidocaine
(cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] Void: To urinate, empty the bladder. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [NIH]
Vomeronasal Organ: A specialized part of the olfactory system located anteriorly in the nasal cavity within the nasal septum. Chemosensitive cells of the vomeronasal organ project via the vomeronasal nerve to the accessory olfactory bulb. The primary function of this organ appears to be in sensing pheromones which regulate reproductive and other social behaviors. While the structure has been thought absent in higher primate adults, data now suggests it may be present in adult humans. [NIH] War: Hostile conflict between organized groups of people. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Whooping Cough: A respiratory infection caused by Bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath. [NIH] Whooping Cough: A respiratory infection caused by Bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath. [NIH] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH]
Dictionary 251
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zoster: A virus infection of the Gasserian ganglion and its nerve branches, characterized by discrete areas of vesiculation of the epithelium of the forehead, the nose, the eyelids, and the cornea together with subepithelial infiltration. [NIH] Zygote: The fertilized ovum. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
253
INDEX 4 4-Aminopyridine, 35, 165 A Abdomen, 133, 165, 176, 177, 205, 208, 210, 211, 224, 225, 240, 244, 248 Abdominal, 56, 73, 127, 165, 178, 181, 190, 208, 209, 222, 225, 229 Abdominal Pain, 127, 165, 209 Ablation, 6, 117, 165 Abrasion, 110, 165 Acetaminophen, 77, 165, 198 Acetylcholine, 7, 165, 182, 218, 219, 223 Acne, 165, 175 Acoustic, 134, 165, 173, 250 Acrylonitrile, 165, 235 Action Potentials, 31, 165 Adaptability, 165, 180 Adaptation, 10, 21, 165, 227 Adenine, 165, 166 Adenocarcinoma, 34, 165, 203 Adenosine, 4, 37, 165, 166, 168, 227, 244 Adenosine Triphosphate, 37, 166, 227 Adjustment, 165, 166 Adjuvant, 59, 61, 120, 166, 199 Adrenal Cortex, 166, 204, 230 Adrenal Medulla, 166, 180, 194, 195, 220 Adrenaline, 43, 117, 166 Adrenergic, 5, 108, 166, 167, 168, 170, 171, 191, 195, 226, 230, 232, 233, 242 Adult-Onset Diabetes, 38, 166 Adverse Effect, 13, 166, 226, 237 Aerobic, 166, 215 Aerosol, 27, 109, 166, 220, 242 Afferent, 15, 20, 28, 36, 68, 114, 166, 211, 229 Affinity, 14, 22, 36, 166, 173, 189, 211, 233, 237, 238 Agar, 166, 227 Agarose, 34, 166 Agonist, 166, 167, 191, 205, 216, 217 Air Embolism, 93, 167 Air Sacs, 167, 168 Airway, 5, 36, 50, 55, 70, 79, 109, 167, 177, 238 Airway Resistance, 5, 167 Akathisia, 167, 171 Albumin, 167, 227 Albuterol, 60, 167
Alertness, 167, 181 Algorithms, 167, 176 Alimentary, 167, 209, 223 Alkaline, 167, 168, 174, 178, 226 Alkalinization, 41, 51, 167 Alkaloid, 167, 173, 178, 183, 215, 222, 232, 244, 247 Allergen, 167, 189, 237 Allergic Rhinitis, 167, 201 Allylamine, 167, 168 Aloe, 113, 167 Alpha Particles, 167, 232 Alpha-1, 168 Alternative medicine, 139, 168 Alum, 124, 168, 183 Aluminum, 113, 124, 168, 241 Alveoli, 168, 249 Amenorrhea, 168, 170 Amine, 29, 168, 203 Amino Acid Sequence, 8, 168, 170 Amiodarone, 34, 62, 168 Amitriptyline, 13, 168 Ammonia, 13, 168, 242, 247 Ammonium Chloride, 13, 168 Amnestic, 168, 214 Amniotic Fluid, 168, 200 Amphetamine, 18, 168, 189 Ampoule, 100, 169 Ampulla, 169, 194 Amputation, 19, 128, 133, 169 Amygdala, 11, 17, 18, 24, 31, 89, 169, 211, 244 Anaesthetic, 51, 67, 100, 103, 109, 114, 169 Anal, 75, 109, 112, 123, 169, 197 Anal Fissure, 75, 112, 169 Analog, 10, 43, 169, 189, 209 Analogous, 36, 122, 169, 192, 246 Anaphylatoxins, 169, 184 Anaphylaxis, 3, 4, 77, 169 Anatomical, 11, 16, 17, 23, 31, 118, 169, 173, 182, 186, 190, 206, 214, 236 Aneurysm, 169, 248 Angina, 169, 170, 209, 219, 230 Angina Pectoris, 169, 230 Anhydrous, 115, 170 Animal model, 14, 18, 24, 27, 35, 170 Ankle, 19, 80, 170, 249 Anorectal, 121, 170
254
Lidocaine
Anorexia, 23, 170, 247 Anorexia Nervosa, 23, 170 Antagonism, 170, 244 Antianginal, 168, 170 Anti-Anxiety Agents, 170, 231, 246 Antiarrhythmic, 8, 12, 29, 88, 116, 168, 170, 214 Antibacterial, 65, 120, 170, 239 Antibiotic, 106, 128, 170, 180, 195, 224, 239, 244 Antibodies, 170, 172, 201, 206, 212 Antibody, 3, 79, 124, 166, 170, 171, 184, 201, 203, 205, 206, 207, 209, 213, 215, 233, 237, 239, 251 Anticholinergic, 168, 170, 191, 227 Anticoagulant, 107, 170, 230 Anticonvulsant, 170, 178, 214, 226, 248 Antidepressive Agents, 170, 231 Antiemetic, 171 Antifungal, 171, 209 Antigen, 3, 166, 169, 170, 171, 172, 184, 203, 205, 206, 207, 213, 214, 237 Antigen-Antibody Complex, 171, 184 Anti-infective, 171, 178, 204, 238 Anti-inflammatory, 25, 100, 106, 115, 123, 129, 133, 165, 171, 190, 200, 209, 217, 246 Anti-Inflammatory Agents, 133, 171, 209 Antimicrobial, 171, 189, 243 Antineoplastic, 120, 171, 176, 247 Antioxidant, 171, 173 Antipruritic, 100, 101, 171, 178 Antipsychotic, 10, 171, 191, 218, 246 Antipsychotic Agents, 171, 191, 246 Antipyretic, 165, 171, 190, 217, 232 Antiserum, 28, 172 Antispasmodics, 25, 172 Antitussive, 172, 189, 221 Antiviral, 120, 172, 224 Anus, 109, 169, 170, 172, 177, 184, 202, 224, 233 Anxiety, 4, 24, 167, 170, 172, 230 Anxiolytic, 98, 172, 214 Aorta, 172, 179, 229, 249 Apnea, 37, 172 Aponeurosis, 172, 199 Apoptosis, 14, 38, 172, 179 Appendicitis, 127, 172 Applicability, 107, 172 Aqueous, 27, 49, 62, 103, 105, 117, 123, 172, 176, 188, 193, 204, 210, 245 Aqueous humor, 172, 176, 245 Arginine, 169, 172, 219
Arrhythmia, 12, 106, 170, 172, 198 Arterial, 5, 89, 128, 133, 167, 172, 205, 219, 231, 243 Arteries, 172, 176, 177, 186, 214, 216 Arterioles, 172, 176, 178, 214, 248 Artery, 75, 84, 169, 172, 177, 179, 186, 197, 212, 232, 236, 245 Arthroscopy, 52, 58, 79, 117, 172 Arthrosis, 108, 172 Articular, 115, 172, 221, 246 Ascorbic Acid, 126, 172, 204 Aspartate, 7, 173, 189, 209 Asphyxia, 173, 220 Assay, 49, 173 Astringent, 113, 173, 241 Astrocytes, 173, 214, 215 Asymptomatic, 38, 173, 198, 222 Atmospheric Pressure, 173, 204 Atracurium, 54, 173 Atrial, 168, 173, 198 Atrioventricular, 173, 238, 242 Atrioventricular Node, 173, 242 Atrium, 97, 173, 179, 238, 242, 249 Atrophy, 102, 108, 173 Atropine, 172, 173 Attenuated, 173, 248 Attenuation, 7, 65, 173 Auditory, 15, 88, 90, 92, 93, 134, 173, 183, 196, 200, 201, 202, 212, 229, 248 Auditory Cortex, 16, 173, 183 Auditory nerve, 134, 173, 212 Aura, 138, 173 Auricular, 91, 173 Autodigestion, 173, 222 Autoimmune disease, 124, 174, 216 Autonomic, 5, 10, 108, 111, 165, 171, 174, 216, 220, 223, 225, 239, 242 Autonomic Nervous System, 5, 174, 223, 225, 239, 242 Autoradiography, 32, 174 Avian, 24, 174 Axilla, 174, 177 Axillary, 57, 66, 174, 177 Axons, 35, 174, 189, 207, 218, 221, 225, 229 Axotomy, 35, 174 B Babesiosis, 174, 232 Bacteria, 120, 121, 170, 171, 174, 185, 195, 197, 214, 233, 235, 239, 245, 246, 248 Bacterial Physiology, 165, 174 Bactericidal, 174, 196 Bacteriophage, 174, 227, 246
255
Bacteriorhodopsin, 97, 174 Bacteriostatic, 174, 195 Barium, 100, 174 Baroreflex, 15, 174 Basal Ganglia, 171, 175, 182, 199, 211, 220 Basophils, 175, 210 Benign, 114, 175, 199, 201, 217, 223, 233, 250 Benzene, 175 Benzocaine, 46, 66, 118, 123, 142, 175 Benzodiazepines, 111, 175 Benzoyl Peroxide, 100, 175 Benzyl Alcohol, 117, 175 Bilateral, 11, 30, 33, 44, 175 Bile, 175, 199, 203, 211, 240, 241, 243 Bile Acids, 175, 240, 243 Biliary, 175, 190, 222 Biliary Tract, 175, 222 Bilirubin, 13, 167, 175 Binding Sites, 14, 22, 175 Bioassay, 58, 175 Bioavailability, 12, 47, 72, 175 Biochemical, 54, 175, 198, 199, 221, 226, 237 Biological Transport, 175, 190 Biopsy, 42, 70, 75, 78, 105, 138, 176 Biotechnology, 39, 40, 139, 149, 176 Biotransformation, 11, 176 Bismuth, 113, 176 Blastocyst, 176, 185 Bleomycin, 91, 176 Bloating, 176, 209 Blood Coagulation, 176, 178, 244 Blood Glucose, 176, 202, 205, 207 Blood Platelets, 176, 237 Blood pressure, 13, 37, 174, 176, 181, 205, 215, 225, 238 Blood transfusion, 176, 202 Blood Viscosity, 176, 202 Blood-Aqueous Barrier, 61, 176 Blood-Brain Barrier, 40, 176, 217, 227 Blot, 35, 177 Body Fluids, 177, 178, 192, 238 Bone Cements, 100, 177 Bone Marrow, 43, 175, 177, 201, 205, 212, 239 Bowel, 109, 126, 127, 169, 177, 208, 210, 240 Bowel Movement, 109, 177, 240 Brachial, 46, 57, 177, 212, 232 Brachial Artery, 177, 232 Brachial Plexus, 46, 57, 177, 212
Brachytherapy, 177, 207, 209, 233, 251 Bradykinin, 177, 219, 227 Brain Stem, 38, 108, 177, 181, 183, 199, 223, 240 Bronchi, 177, 195, 196, 209, 244, 246 Bronchial, 177, 203, 244 Bronchiseptica, 177, 225 Bronchoconstriction, 5, 44, 60, 177 Bronchodilator, 177, 209 Bronchopulmonary, 5, 177 Bronchoscopy, 48, 68, 76, 177 Bronchus, 177, 178 Buccal, 84, 178, 240 Buffers, 174, 178 Burns, 60, 175, 178 Bursitis, 51, 95, 127, 178 Bypass, 132, 178 C Caesarean section, 85, 178 Calcium, 14, 21, 97, 115, 132, 177, 178, 183, 184, 222 Calcium Channels, 178, 222 Camphor, 101, 178 Cannula, 8, 178 Capillary, 102, 176, 177, 178, 249 Capsaicin, 21, 50, 104, 111, 133, 178 Capsules, 178, 191, 199 Carbamazepine, 69, 91, 111, 178 Carbohydrate, 178, 200, 228 Carbon Dioxide, 179, 188, 197, 199, 234 Carcinogen, 179, 247 Carcinogenic, 175, 179, 207, 240, 247 Carcinoma, 179 Cardiac arrest, 13, 34, 46, 179, 242 Cardiac Output, 175, 179 Cardiopulmonary, 4, 56, 87, 89, 179, 202 Cardiopulmonary Bypass, 56, 179, 202 Cardiopulmonary Resuscitation, 87, 89, 179 Cardiorespiratory, 179, 215 Cardioselective, 179, 230 Cardiotoxic, 8, 179 Cardiovascular, 28, 29, 46, 50, 57, 169, 173, 178, 179, 190, 237, 239 Carotene, 179, 234 Carotid Body, 5, 179, 181 Carpal Tunnel Syndrome, 127, 179 Carrier Proteins, 179, 227 Case report, 4, 62, 92, 179, 183 Caspase, 14, 179 Cataract, 43, 47, 50, 52, 53, 60, 61, 84, 92, 103, 180, 195
256
Lidocaine
Catecholamine, 102, 170, 180, 191, 226 Catheter, 40, 81, 122, 132, 133, 180, 208 Catheterization, 52, 80, 180, 208 Caudal, 23, 89, 180, 190, 205, 220, 228 Caudate Nucleus, 180, 186, 220 Causal, 14, 16, 35, 180, 235, 243 Cause of Death, 13, 180 Ceftriaxone, 39, 47, 180 Cell Death, 14, 38, 172, 180, 217 Cell Division, 174, 180, 188, 213, 215, 227, 230 Cell membrane, 175, 178, 179, 180, 189, 199, 227, 229, 238, 250 Cell Respiration, 180, 215, 234 Cell Size, 180, 198 Cellobiose, 180 Cellulose, 117, 180, 199, 214, 227 Central Nervous System Infections, 180, 201, 204 Central Nervous System Stimulants, 132, 181 Cerebellar, 84, 181, 183, 234, 246 Cerebellar Diseases, 181, 246 Cerebellum, 181, 187, 228, 234 Cerebral Cortex, 7, 16, 181, 196, 197 Cerebral hemispheres, 175, 177, 181, 243 Cerebral Palsy, 181, 239 Cerebrum, 181, 187, 243 Cervical, 48, 177, 181, 212 Cervical Plexus, 48, 181 Cervix, 181 Cesarean Section, 55, 59, 181 Character, 169, 181, 188, 233 Chemoembolization, 46, 57, 181 Chemoreceptor, 5, 15, 171, 181 Chemotactic Factors, 181, 184 Chemotaxis, 63, 182 Chimeras, 8, 182 Chin, 107, 113, 182, 213 Cholesterol, 175, 182, 240 Choline, 123, 182 Cholinergic, 168, 171, 182, 223 Cholinesterase Inhibitors, 182, 223 Chorea, 171, 182 Chromatin, 172, 182, 194 Chromosomal, 182, 199, 236 Chromosome, 182, 185, 211, 236 Ciliary, 172, 176, 182, 220 Ciliary Body, 176, 182 Cinchona, 182, 232 Circadian, 27, 182 Circulatory system, 167, 182, 193
Circumcision, 51, 65, 105, 138, 183 Cirrhosis, 57, 71, 183 CIS, 183, 234 Citric Acid, 102, 183 Clamp, 13, 21, 36, 183 Clinical study, 183, 186 Clinical trial, 4, 25, 34, 38, 111, 149, 183, 186, 192, 231, 233 Cloning, 176, 183 Coca, 183 Cocaine, 10, 17, 27, 37, 67, 82, 84, 89, 110, 117, 130, 134, 183 Cochlea, 132, 183, 207, 235, 240, 247 Cochlear, 78, 134, 183, 240, 245, 249, 250 Cochlear Diseases, 183, 245 Cochlear Nerve, 134, 183, 240, 249 Cochlear Nucleus, 183, 250 Codeine, 183, 189, 221 Coenzyme, 172, 183 Cognition, 11, 184, 218 Colitis, 127, 184, 209 Collagen, 126, 168, 184, 197, 199, 204, 227, 230 Collagen disease, 184, 204 Collapse, 169, 184, 238 Colloidal, 167, 184, 225, 242 Colon, 127, 184, 209, 210 Colorectal, 28, 184 Communication Disorders, 16, 135, 148, 184 Complement, 16, 36, 169, 184, 185, 227, 237 Complementary and alternative medicine, 87, 95, 185 Complementary medicine, 87, 185 Compliance, 111, 185 Compress, 185, 245 Computational Biology, 149, 185 Conception, 129, 185, 197 Concomitant, 10, 13, 23, 107, 185 Conduction, 19, 31, 106, 107, 122, 130, 173, 185, 244 Cone, 185, 242 Congenita, 185, 232 Congestion, 171, 185, 195 Conjugated, 185, 187 Conjugation, 176, 185 Conjunctiva, 185, 219, 227, 247 Conjunctivitis, 185, 201 Connective Tissue, 172, 177, 184, 185, 186, 189, 197, 199, 212, 213, 225, 235, 243
257
Consciousness, 6, 107, 169, 170, 186, 188, 189, 191, 231, 234, 243 Constipation, 111, 171, 186, 209 Constrict, 186, 216 Constriction, 186, 209, 220, 236, 248 Constriction, Pathologic, 186, 248 Consummatory Behavior, 11, 186 Contact dermatitis, 123, 186 Contamination, 43, 107, 121, 186, 203 Contractility, 90, 186 Contraindications, ii, 186 Contralateral, 30, 186, 234 Contrast medium, 186, 205 Controlled clinical trial, 43, 186 Controlled study, 42, 45, 53, 59, 78, 186 Contusions, 127, 186 Convalescence, 114, 186 Coordination, 17, 23, 181, 186, 216 Cornea, 110, 172, 186, 219, 232, 251 Corneal Stroma, 110, 186 Corneum, 103, 105, 186, 195 Coronary, 169, 173, 186, 214, 216, 219 Coronary Thrombosis, 186, 214, 216 Corpus, 186, 200, 224, 230 Corpus Striatum, 186, 200 Cortex, 7, 11, 16, 21, 24, 108, 187, 194, 196, 221, 229, 234 Cortical, 11, 16, 21, 37, 187, 196, 229, 236 Cortices, 18, 187, 202 Craniocerebral Trauma, 187, 201, 204, 245 Cribriform, 187, 220 Critical Care, 44, 93, 187 Cues, 9, 10, 18, 24, 187 Curare, 187, 216, 247 Curative, 187, 244 Curettage, 187, 211 Cutaneous, 7, 26, 28, 32, 43, 48, 49, 58, 111, 181, 186, 187, 223 Cyclic, 187, 201, 219, 244 Cysteine, 22, 36, 187 Cystine, 187 Cystitis, 133, 154, 187 Cytochrome, 11, 14, 48, 187 Cytogenetics, 187, 236 Cytokine, 39, 188 Cytoplasm, 172, 175, 180, 188, 194, 243 Cytotoxicity, 37, 91, 167, 188 D Dacryocystorhinostomy, 84, 188 Deamination, 188, 247 Decarboxylation, 188, 203, 216 Decompression, 46, 75, 188
Decompression Sickness, 188 Decubitus, 188, 238 Decubitus Ulcer, 188, 238 Defecation, 113, 188 Degenerative, 24, 188, 203, 221 Deletion, 172, 188 Delirium, 171, 188 Dementia, 171, 188 Dendrites, 20, 189, 218, 220 Dendritic, 189, 239 Density, 37, 189, 198, 221, 228, 239 Dentate Gyrus, 189, 203 Dentists, 129, 189 Depolarization, 20, 36, 189, 191 Dermal, 19, 26, 104, 105, 119, 120, 189 Dermatitis, 55, 63, 189 Dermatology, 49, 54, 117, 189 Dermis, 111, 189, 234, 242, 246 Desensitization, 189, 206 Desipramine, 38, 189 Detergents, 189, 238 Detoxification, 12, 189 Deuterium, 189, 204 Dexmedetomidine, 41, 189 Dextroamphetamine, 169, 189 Dextromethorphan, 26, 49, 189 Diabetes Mellitus, 190, 202 Diabetic Foot, 133, 190 Diagnostic procedure, 99, 110, 139, 190 Dialyzer, 190, 202 Diaphragm, 181, 190, 203 Diarrhea, 190, 209 Diastole, 190 Diastolic, 38, 190, 205 Diclofenac, 129, 190 Diclofenac Sodium, 190 Dicyclomine, 172, 190 Diencephalon, 190, 205, 224, 229, 243, 244 Diffusion, 50, 102, 116, 175, 190, 207 Digestion, 167, 175, 177, 190, 208, 211, 224, 240, 248 Dilatation, Pathologic, 190, 248 Dilation, 79, 177, 190, 204, 216, 248 Dilator, 190, 219 Dimethyl, 100, 102, 190 Diphtheria, 79, 190 Direct, iii, 5, 14, 17, 21, 29, 34, 49, 103, 132, 134, 141, 181, 190, 191, 204, 222, 232, 234, 242 Discrete, 5, 17, 190, 243, 251 Disinfectant, 136, 191, 196 Disopyramide, 92, 191
258
Lidocaine
Dissociation, 166, 191, 208 Distal, 9, 19, 20, 191, 193, 225, 229 Diuresis, 191, 244 Diuretic, 168, 191, 209 Dizziness, 191, 249 Dopamine, 132, 168, 171, 183, 189, 191, 215, 219, 226 Dopamine Agonists, 132, 191 Dopamine Antagonists, 132, 191 Dorsal, 11, 14, 16, 20, 27, 32, 35, 38, 111, 112, 114, 183, 191, 228, 240 Dorsum, 191, 199 Dosage Forms, 84, 115, 116, 191 Dose-dependent, 90, 192 Double-blind, 19, 34, 38, 43, 45, 46, 47, 51, 53, 56, 57, 65, 73, 93, 192 Double-blinded, 38, 57, 93, 192 Drive, ii, vi, 32, 36, 83, 133, 192 Drug Delivery Systems, 97, 116, 132, 192 Drug Design, 13, 192 Drug Interactions, 142, 143, 192 Drug Tolerance, 192, 245 Duct, 169, 178, 180, 188, 192, 212, 242 Duodenum, 175, 192, 194, 240 Dyskinesia, 171, 192 Dysmenorrhea, 192, 217 Dysphagia, 135, 192 Dysphonia, 79, 192 Dyspnea, 4, 192 Dystrophy, 108, 192 E Edema, 108, 109, 186, 192, 208, 247, 249 Effector, 17, 165, 184, 192, 218 Efferent, 16, 36, 192, 215 Ejaculation, 71, 78, 193, 237 Elastic, 193, 239, 242, 245 Elastin, 184, 193 Elective, 55, 193 Electric shock, 179, 193 Electrode, 20, 193 Electrolyte, 117, 188, 193, 229, 238, 247 Electrons, 171, 193, 208, 222, 232, 233 Electrophysiological, 35, 39, 193 Embolism, 89, 193 Embryo, 176, 193, 206 Emodin, 167, 193 Emollient, 193, 200, 210, 220 Empiric, 38, 54, 193 Emulsion, 104, 174, 193, 198 Encapsulated, 123, 193, 211 Endocrine System, 193, 218 Endocrinology, 193, 201
Endogenous, 191, 193, 194, 230 Endometrial, 42, 138, 194 Endometrium, 194 Endorphins, 194, 219 Endoscope, 194, 210 Endoscopic, 66, 117, 134, 135, 172, 177, 194, 214 Endothelial cell, 60, 176, 194, 244 Endothelium, 61, 194, 219 Endothelium, Lymphatic, 194 Endothelium, Vascular, 194 Endothelium-derived, 194, 219 Endotoxins, 184, 194 Endotracheal intubation, 55, 61, 68, 73, 194 Enhancers, 9, 120, 194 Enkephalins, 194, 219 Entorhinal Cortex, 24, 194, 203 Environmental Health, 148, 150, 194 Enzymatic, 136, 168, 178, 179, 184, 194, 203, 234 Enzyme, 179, 184, 192, 194, 201, 204, 215, 227, 231, 241, 244, 250, 251 Enzyme Inhibitors, 194, 227 Eosinophils, 194, 210 Epidemics, 132, 194 Epidermal, 64, 195, 250 Epidermal Growth Factor, 64, 195 Epidermis, 186, 189, 195 Epidural, 44, 47, 48, 49, 55, 56, 58, 65, 71, 73, 74, 76, 81, 88, 89, 90, 195 Epithelial, 64, 110, 165, 175, 182, 195, 203, 223 Epithelial Cells, 64, 195, 203 Epithelium, 21, 110, 176, 194, 195, 209, 221, 251 Equipment and Supplies, 136, 195 Ergot, 124, 195 Erythema, 120, 186, 195, 248 Erythrocytes, 174, 177, 195, 237 Erythromycin, 55, 195 Esophagitis, 195, 241 Esophagus, 103, 195, 226, 234, 240 Esotropia, 195, 241 Essential Tremor, 9, 195 Ethanol, 50, 195 Ether, 101, 196 Ethmoid, 196, 220 Etidocaine, 110, 196 Eukaryotic Cells, 196, 206, 221 Evacuation, 186, 196, 210 Evoke, 30, 196, 240
259
Evoked Potentials, 88, 93, 196 Excitability, 18, 23, 196, 217, 232 Excitation, 15, 17, 181, 196, 198, 219 Excitatory, 25, 28, 30, 196, 200, 205 Exogenous, 13, 176, 191, 193, 196, 230 Exotropia, 196, 241 Expectorant, 168, 196 Expiration, 196, 234 External-beam radiation, 196, 209, 233, 251 Extracellular, 14, 20, 173, 185, 186, 196, 197, 214, 238 Extracellular Space, 196, 214 Extraction, 12, 47, 102, 181, 196 Extrapyramidal, 167, 171, 191, 196 Extrasystole, 106, 196 Extremity, 14, 41, 133, 177, 197, 212, 236 Eye Movements, 16, 197 F Facial, 16, 197, 199, 212, 239, 243 Fallopian tube, 197, 205 Family Planning, 149, 197 Fat, 54, 81, 177, 179, 188, 197, 210, 211, 216, 235, 239, 242 Fatigue, 197, 202 Feces, 186, 197, 240 Femoral, 179, 197 Femoral Artery, 179, 197 Fentanyl, 41, 52, 54, 55, 64, 67, 82, 197 Fetus, 181, 197, 229, 248 Fibrillation, 31, 197 Fibrinogen, 197, 227, 244 Fibroblasts, 197, 215 Fibrosis, 167, 197, 236 Fissure, 113, 189, 197, 229 Fixation, 100, 197, 235, 237 Flatus, 198, 199 Flecainide, 12, 198 Flow Cytometry, 14, 198 Fluorescence, 14, 198 Fluorescent Dyes, 198 Fluoroscopy, 136, 198 Fold, 14, 36, 197, 198, 219, 229 Foot Ulcer, 133, 190, 198 Foramen, 182, 198, 212, 225 Forearm, 176, 198, 212, 232 Fovea, 197, 198 Free Radicals, 15, 171, 191, 198 Friction, 167, 198, 211 Frontal Lobe, 198, 229 Fulminant Hepatic Failure, 13, 198 Fungi, 171, 185, 198, 199, 214, 248, 251
Fungus, 195, 199 G Gallbladder, 165, 175, 199 Ganglia, 35, 165, 199, 218, 223, 225, 242 Ganglion, 14, 21, 27, 111, 112, 199, 220, 221, 240, 250, 251 Gap Junctions, 199 Gas, 49, 89, 100, 168, 179, 188, 190, 198, 199, 204, 209, 219, 220, 232, 234, 242, 249 Gas exchange, 199, 234, 249 Gastric, 174, 191, 195, 199, 203, 224 Gastrin, 199, 203 Gastritis, 199, 241 Gastrointestinal, 11, 77, 116, 132, 177, 182, 190, 195, 199, 224, 237, 239, 241 Gastrointestinal tract, 182, 195, 199, 224, 237 Gelatin, 199, 200, 242, 244 Gene, 18, 23, 25, 176, 199, 203, 209, 211, 227 Gene Expression, 25, 199 Genetic Techniques, 12, 199 Genetics, 185, 187, 199 Geniculate Ganglion, 21, 199 Genital, 71, 119, 200, 201 Genotype, 200, 226 Geriatric, 56, 128, 200 Germ Cells, 200, 213, 239 Gestational, 88, 200 Gestational Age, 88, 200 Gland, 166, 200, 205, 212, 222, 230, 236, 240, 241, 242, 244 Globus Pallidus, 20, 186, 200 Glomeruli, 200, 220 Glottis, 200, 203, 225 Glucocorticoid, 200, 204, 246 Glucose, 10, 38, 84, 105, 142, 172, 176, 180, 190, 200, 202, 207, 236 Glucuronic Acid, 200, 202 Glutamate, 7, 17, 18, 132, 190, 200 Glutamic Acid, 102, 132, 200, 219, 230 Glycerol, 109, 200, 226 Glycine, 102, 168, 200, 219 Glycoprotein, 197, 200, 201, 244, 247 Gonadal, 200, 240 Goniotomy, 200, 246 Gout, 200, 217 Governing Board, 201, 229 Gp120, 201, 224 Graft, 43, 201 Grafting, 201, 206 Graft-versus-host disease, 43, 201
260
Lidocaine
Gravis, 201, 217 Guanidine, 191, 201 Guanylate Cyclase, 201, 219 Gynecology, 38, 42, 61, 72, 75, 78, 81, 117, 201 H Habitat, 201, 219 Hair Cells, 183, 201, 240 Hair follicles, 189, 201 Half-Life, 106, 180, 201 Haptens, 166, 201 Hay Fever, 3, 4, 167, 201 Headache, 62, 95, 201, 204, 229 Headache Disorders, 201 Hearing Disorders, 184, 202 Heart Arrest, 179, 202 Heart attack, 37, 108, 202 Heart failure, 15, 37, 202 Heartbeat, 202, 242, 249 Hematopoiesis, 120, 202 Heme, 175, 187, 202 Hemodialysis, 45, 190, 202 Hemodilution, 93, 202 Hemodynamics, 52, 202 Hemoglobin, 105, 195, 202 Hemorrhage, 186, 187, 201, 202, 241 Hemorrhoid, 121, 124, 202, 244 Hemostasis, 202, 237 Heparin, 107, 133, 202 Hepatic, 11, 56, 57, 58, 167, 188, 202 Hepatitis, 57, 58, 79, 124, 198, 203 Hepatitis A, 57, 203 Hepatocellular, 46, 203 Hepatocellular carcinoma, 46, 203 Hepatocytes, 13, 203 Hepatovirus, 203 Heredity, 199, 203 Herpes, 70, 106, 111, 112, 119, 129, 130, 203 Herpes Zoster, 106, 112, 203 Heterogeneity, 166, 203 Heterotropia, 203, 241 Hiccup, 132, 191, 203 Hippocampus, 6, 8, 11, 24, 189, 203, 211, 241 Histamine, 169, 171, 203 Histology, 57, 203 Hoarseness, 203, 210 Homologous, 202, 203, 237, 243 Homozygotes, 27, 203 Hormonal, 101, 173, 203, 224
Hormone, 6, 166, 175, 195, 199, 203, 207, 213, 230, 235, 243, 244 Humoral, 15, 120, 203 Humour, 49, 203 Hyaluronidase, 50, 59, 204 Hybrid, 12, 204 Hydrocephalus, 204, 208, 209 Hydrocortisone, 101, 106, 121, 204 Hydrogel, 126, 204 Hydrogen, 115, 121, 168, 178, 189, 204, 215, 219, 222, 231 Hydrogen Peroxide, 121, 204 Hydrogenation, 175, 204 Hydrolysis, 176, 180, 204, 228, 231 Hydrophobic, 12, 116, 189, 204 Hydroxylysine, 184, 204 Hydroxyproline, 168, 184, 204 Hygienic, 204, 238 Hyperalgesia, 50, 51, 66, 204 Hyperbaric, 40, 59, 67, 89, 92, 93, 204 Hyperbaric oxygen, 89, 93, 204 Hyperreflexia, 205, 243 Hypersensitivity, 27, 32, 49, 167, 169, 189, 205, 235, 237 Hypertension, 23, 82, 205, 208, 226, 230, 247 Hyperthyroidism, 205, 230 Hypnotic, 205, 214 Hypoglycemia, 10, 205 Hypoglycemic, 10, 205 Hypopharynx, 136, 205 Hypotension, 59, 111, 171, 205 Hypothalamic, 10, 205 Hypothalamus, 174, 190, 205, 211 Hypothermia, 122, 202, 205 Hysterosalpingography, 61, 78, 205 Hysterotomy, 181, 205 I Ibotenic Acid, 205, 216 Illusion, 205, 249 Imidazole, 115, 203, 205 Immune adjuvant, 168, 205 Immune response, 101, 120, 124, 166, 168, 171, 174, 201, 205, 206, 237, 241, 248, 250 Immune system, 120, 205, 206, 212, 216, 250 Immunization, 205, 237 Immunodeficiency, 124, 205 Immunodeficiency syndrome, 124, 205 Immunoglobulin, 3, 170, 205, 215 Immunohistochemistry, 23, 24, 205 Immunologic, 181, 200, 205, 206, 233
261
Immunology, 68, 78, 166, 198, 206 Immunosuppression, 19, 206, 212 Immunosuppressive, 102, 200, 206 Immunosuppressive Agents, 206 Impairment, 111, 188, 192, 206, 213, 231, 249 Implant radiation, 206, 207, 209, 233, 251 Implantation, 20, 185, 206 Impotence, 78, 206, 222 In situ, 32, 206 In Situ Hybridization, 32, 206 In vitro, 13, 14, 30, 35, 38, 44, 50, 55, 65, 67, 84, 93, 176, 206 In vivo, 7, 13, 20, 30, 31, 35, 44, 48, 84, 97, 100, 202, 206, 212, 214 Incision, 65, 84, 114, 115, 117, 178, 200, 205, 206, 208 Incontinence, 122, 133, 190, 204, 206, 216 Incubation, 206, 225 Incubation period, 206, 225 Induction, 14, 18, 37, 52, 90, 171, 206, 209 Infarction, 204, 206 Infiltration, 45, 46, 51, 56, 65, 75, 82, 84, 92, 102, 106, 207, 229, 251 Infusion, 18, 24, 40, 43, 61, 62, 78, 80, 88, 207 Ingestion, 23, 207, 228 Inhalation, 109, 166, 203, 207, 209, 228 Initiation, 19, 207 Initiator, 100, 207 Inner ear, 132, 138, 180, 183, 207 Innervation, 177, 207, 212, 225, 236, 244 Inorganic, 123, 207 Inotropic, 191, 207 Insight, 10, 18, 207 Insomnia, 91, 207, 229 Instillation, 94, 207 Insulator, 207, 216 Insulin, 10, 207 Insulin-dependent diabetes mellitus, 207 Internal radiation, 207, 209, 233, 251 Interneurons, 23, 207 Interstitial, 133, 154, 177, 196, 207, 209, 251 Intestine, 177, 208, 210 Intoxication, 94, 188, 208, 251 Intracellular, 20, 21, 29, 37, 199, 207, 208, 213, 219, 228, 233, 235 Intracranial Hypertension, 201, 204, 208, 245 Intramuscular, 39, 68, 79, 80, 90, 123, 208, 223, 246 Intraocular, 61, 65, 103, 110, 208
Intraocular pressure, 61, 65, 110, 208 Intraperitoneal, 47, 61, 208 Intrathecal, 14, 41, 51, 69, 70, 77, 208 Intravenous Anesthetics, 89, 208 Intravesical, 50, 62, 79, 138, 208 Intrinsic, 14, 23, 36, 105, 166, 208 Intubation, 50, 60, 65, 66, 70, 76, 82, 87, 89, 93, 110, 180, 208 Invasive, 27, 34, 107, 117, 127, 208, 212 Involuntary, 182, 195, 197, 208, 217, 234, 238, 239 Ion Channels, 20, 173, 208, 226 Ion Exchange, 180, 208 Ionization, 208 Ions, 178, 191, 193, 201, 204, 208, 215, 229, 238 Iontophoresis, 42, 48, 72, 106, 208 Ipsilateral, 27, 30, 209, 234 Iris, 186, 200, 209, 232 Irradiation, 100, 209, 251 Irritable Bowel Syndrome, 7, 127, 209 Ischemia, 6, 31, 112, 133, 169, 173, 188, 209, 216 Isoflurane, 6, 72, 209 Isopropyl, 105, 209 Isoproterenol, 40, 209 Isosorbide, 113, 209 Isosorbide Dinitrate, 113, 209 K Kb, 148, 209 Ketamine, 50, 209 Ketoconazole, 55, 209 Ketorolac, 88, 209 Kidney stone, 125, 209 Kinetic, 8, 12, 22, 209 L Labile, 184, 209 Labyrinth, 183, 207, 209, 230, 237, 249 Laceration, 73, 210, 243 Lacrimal, 188, 210, 217 Language Disorders, 184, 210 Lanolin, 101, 210 Laparoscopy, 47, 61, 210 Large Intestine, 208, 210, 233, 238 Laryngeal, 134, 210 Laryngitis, 64, 210 Laryngoscope, 91, 136, 210 Laryngoscopy, 110, 134, 210 Larynx, 43, 134, 136, 200, 205, 210, 246, 248, 250 Latency, 5, 93, 210 Latent, 112, 210
262
Lidocaine
Laxative, 166, 193, 210, 214 Lens, 172, 180, 185, 210 Leprosy, 198, 210 Lesion, 32, 52, 198, 210, 211, 237, 243, 247 Lethal, 89, 174, 210 Leukocytes, 124, 175, 177, 181, 194, 210, 215, 247 Levorphanol, 189, 210 Ligament, 46, 127, 197, 210, 230 Ligands, 22, 210, 233 Ligation, 32, 112, 210 Limbic, 11, 16, 169, 211, 229 Limbic System, 169, 211, 229 Lingual Nerve, 21, 211 Linkage, 36, 180, 211 Lipectomy, 81, 211 Lipid, 182, 200, 207, 211, 214, 216 Lipophilic, 117, 211 Liposomal, 77, 92, 123, 211 Liposomes, 123, 211 Lithium, 171, 211 Liver Transplantation, 58, 72, 211 Localization, 205, 211 Localized, 8, 97, 129, 130, 190, 193, 197, 207, 211, 216, 221, 227, 243, 244, 247, 248 Locomotion, 17, 18, 211, 227 Locomotor, 17, 18, 27, 211 Long-Term Potentiation, 8, 211 Lubricants, 211, 212, 225 Lubrication, 41, 211 Lumbar, 35, 65, 74, 212, 236, 244 Lymph, 174, 181, 182, 194, 203, 212, 241 Lymph node, 174, 181, 212 Lymphatic, 194, 207, 212, 214, 228, 239 Lymphocyte, 43, 124, 171, 206, 212, 213, 215 Lymphocyte Depletion, 206, 212 Lysine, 102, 204, 212 M Magnetic Resonance Imaging, 7, 69, 212 Malignant, 165, 171, 212, 217, 233 Malnutrition, 167, 173, 212 Mandible, 182, 212 Mandibular Nerve, 211, 212 Manic, 171, 211, 212, 231 Manifest, 212, 241 Mastication, 212, 247 Masticatory, 23, 212 Meatus, 200, 212, 248 Medial, 6, 7, 24, 31, 183, 196, 200, 212, 219, 235, 244 Median Nerve, 51, 54, 179, 212
Mediate, 5, 16, 18, 23, 31, 36, 104, 183, 191, 213 Mediator, 213, 237 Medical Staff, 192, 213 Medicament, 101, 125, 213, 242 MEDLINE, 149, 213 Medullary, 28, 189, 213 Meiosis, 213, 243 Melanin, 209, 213, 226, 247 Membrane Proteins, 211, 213 Memory, 6, 8, 10, 16, 24, 39, 170, 188, 211, 213 Meninges, 180, 187, 213 Menopause, 213, 230 Mental, iv, 4, 24, 148, 150, 181, 182, 184, 188, 191, 197, 213, 231, 236, 247 Mental Health, iv, 4, 148, 150, 213, 231 Mental Retardation, 184, 213 Menthol, 101, 105, 213 Meperidine, 54, 213 Mercury, 124, 198, 213 Mesenchymal, 195, 213 Mesolimbic, 171, 214, 249 Metabolite, 176, 190, 214 Metastasis, 34, 214 Metastatic, 34, 214, 236 Methacrylate, 100, 214 Methionine, 190, 214 Methylcellulose, 84, 214 Mexiletine, 19, 69, 111, 133, 214 MI, 51, 61, 68, 82, 93, 123, 163, 214 Microbe, 214, 245 Microbiology, 165, 214 Microcirculation, 202, 214 Microdialysis, 17, 18, 32, 214 Microglia, 173, 214, 215 Microorganism, 214, 250 Microspheres, 97, 115, 214 Midazolam, 11, 72, 90, 214 Migration, 111, 215 Mitochondria, 14, 37, 215, 221 Mitochondrial Swelling, 215, 217 Mitosis, 111, 172, 215 Modeling, 192, 215 Modification, 8, 29, 71, 168, 215, 232 Molecular Conformation, 29, 215 Molecular Structure, 215, 246 Molecule, 12, 37, 171, 175, 183, 184, 191, 192, 194, 196, 201, 204, 215, 222, 228, 233, 249 Monitor, 136, 215, 220 Monoamine, 31, 168, 170, 189, 215
263
Monoclonal, 209, 215, 233, 251 Monocyte, 63, 215 Monocyte Chemoattractant Protein-1, 63, 215 Mononuclear, 215, 247 Morphine, 11, 19, 33, 56, 65, 73, 85, 183, 213, 215, 217, 221 Morphology, 180, 215 Motility, 215, 237 Motor nerve, 215, 216, 220 Mucinous, 199, 215 Mucosa, 11, 59, 71, 101, 116, 216, 217, 240, 241 Mucositis, 216, 244 Multiple sclerosis, 122, 165, 216 Muscimol, 10, 17, 20, 216 Muscle relaxant, 132, 170, 216, 217, 226, 241 Muscle Relaxation, 216, 217, 241 Muscle Spasticity, 122, 216 Muscle Spindles, 216, 226 Muscle tension, 79, 216 Muscular Dystrophies, 192, 216 Mutagenesis, 8, 13, 22, 216 Mutagens, 216 Myalgia, 54, 216 Myasthenia, 201, 216, 217 Mydriasis, 69, 216 Mydriatic, 190, 216 Myelin, 216, 237 Myelitis, 112, 216 Myocardial infarction, 68, 80, 106, 108, 171, 186, 214, 216, 230 Myocarditis, 190, 216 Myocardium, 169, 214, 216, 217 Myopia, 217, 232, 234 Myotonia, 217, 232 N Nalbuphine, 67, 217 Naproxen, 42, 217 Narcosis, 217 Narcotic, 111, 114, 132, 197, 210, 213, 215, 217, 220 Nasal Cavity, 217, 250 Nasal Mucosa, 79, 217 Nasogastric, 43, 69, 82, 217 Nasolacrimal, 188, 217 Nasopharynx, 136, 217 Nausea, 171, 191, 217, 229, 247 Nearsightedness, 217, 232 Necrosis, 14, 125, 172, 206, 214, 216, 217 Neonatal, 51, 65, 69, 217
Neoplasia, 217 Neoplasm, 217, 223, 247 Neoplastic, 120, 204, 217 Neostigmine, 70, 217 Nephrosis, 124, 217 Nerve Endings, 35, 117, 175, 218, 220 Nerve Fibers, 35, 111, 175, 177, 181, 183, 218, 244 Nerve Growth Factor, 218, 219 Neural Pathways, 4, 218 Neuralgia, 19, 106, 108, 111, 112, 218, 228 Neuroanatomy, 15, 25, 211, 218 Neuroeffector Junction, 218 Neuroendocrine, 10, 218 Neuroleptic, 167, 171, 218 Neurologic, 14, 34, 49, 51, 69, 122, 133, 170, 204, 218 Neuroma, 35, 134, 218 Neuromuscular, 110, 165, 173, 218, 244, 247 Neuromuscular Blocking Agents, 173, 218 Neuromuscular Junction, 165, 218 Neuronal, 11, 13, 14, 17, 18, 19, 25, 174, 178, 217, 218, 225 Neuropathy, 19, 111, 219, 225 Neuropeptide, 27, 219 Neurophysiology, 189, 219 Neurosurgery, 117, 219 Neurotoxic, 14, 205, 216, 219 Neurotoxicity, 14, 69, 190, 219 Neurotoxin, 8, 15, 219 Neurotransmitter, 6, 23, 31, 165, 166, 168, 177, 182, 191, 200, 203, 208, 219, 220, 241 Neurotrophins, 35, 219 Neutrons, 167, 209, 219, 232, 233 Neutrophil, 53, 219 Niche, 132, 219 Nictitating Membrane, 9, 219 Nitric Oxide, 38, 219 Nitrogen, 166, 167, 168, 188, 197, 219, 220, 247 Nitroglycerin, 53, 112, 113, 209, 219 Nitrous Oxide, 60, 220 Nociceptors, 114, 220 Nonverbal Communication, 184, 220 Norepinephrine, 166, 168, 189, 191, 219, 220, 233 Nuclear, 15, 175, 185, 193, 196, 199, 211, 217, 220, 244 Nucleic acid, 206, 216, 219, 220 Nucleus Accumbens, 17, 18, 220, 249
264
Lidocaine
O Ocular, 112, 195, 196, 220, 235 Oculomotor, 16, 216, 220 Oculomotor Nerve, 216, 220 Ointments, 103, 109, 191, 220, 238 Olfactory Bulb, 24, 220, 221, 250 Olfactory Nerve, 220 Opacity, 180, 189, 221 Ophthalmic, 110, 221 Ophthalmology, 48, 61, 63, 74, 84, 197, 221 Opiate, 215, 221 Opium, 215, 221, 222 Opsin, 221, 234, 235 Optic cup, 221, 224 Optic Nerve, 221, 224, 234 Oral Health, 118, 221 Oral Hygiene, 101, 221 Organelles, 37, 188, 221, 227 Orgasm, 193, 221 Oropharynx, 136, 205, 221 Orthopaedic, 100, 107, 221 Orthostatic, 111, 171, 221 Osmotic, 167, 209, 215, 221 Osteoarthritis, 64, 221 Osteomyelitis, 133, 221 Otolaryngology, 64, 134, 221 Otology, 94, 134, 222 Otorhinolaryngology, 117, 134, 222 Outpatient, 52, 70, 81, 84, 222 Ovaries, 222, 237, 244 Overactive bladder, 50, 222 Overdosage, 88, 222 Overdose, 198, 222 Oxidation, 171, 176, 187, 222 Oxidation-Reduction, 176, 222 Oxygen Consumption, 222, 234 Oxygenator, 179, 222 P Palate, 200, 217, 222, 240, 243 Palliative, 92, 222, 244 Pancreas, 165, 207, 222 Pancreatic, 222 Pancreatitis, 77, 222 Papaverine, 84, 221, 222 Papilla, 77, 223 Papilloma, 119, 223 Paradoxical, 33, 223 Paralysis, 187, 195, 223, 239, 244 Parasite, 64, 223 Parasitic, 124, 223, 235 Parasympathetic Nervous System, 223 Parasympathomimetics, 132, 223
Parenteral, 90, 102, 114, 129, 130, 142, 169, 223 Parenteral Nutrition, 90, 223 Paresthesia, 223, 244 Parietal, 16, 223, 239 Parietal Lobe, 223, 239 Parkinsonism, 171, 223 Paroxysmal, 169, 173, 202, 223, 225, 250 Particle, 223, 239, 246 Patch, 21, 30, 36, 43, 46, 48, 52, 53, 55, 64, 69, 76, 79, 92, 127, 223, 246 Pathogenesis, 134, 223 Pathologic, 172, 176, 186, 205, 223 Pathologic Processes, 172, 223 Pathophysiology, 37, 124, 132, 133, 224 Patient Compliance, 102, 224 Pedicle, 56, 224 Pelvic, 224, 230 Pelvis, 165, 212, 222, 224, 248 Penicillin, 100, 170, 224 Penis, 193, 224, 225, 229 Pentosan polysulfate, 133, 224 Peptic, 224, 241 Peptide, 21, 27, 29, 168, 224, 228, 231 Peptide T, 29, 224 Perception, 16, 128, 185, 202, 224, 236 Perforation, 198, 224, 246 Perfusion, 90, 138, 224, 245 Perineal, 75, 224 Perineum, 133, 224 Periodicity, 119, 129, 224 Periodontal disease, 118, 224 Periodontitis, 73, 224 Perioperative, 73, 114, 224 Peripheral Nerves, 108, 210, 224, 228, 240 Peripheral Nervous System, 194, 219, 225, 229, 241 Peripheral Neuropathy, 19, 133, 225 Peripheral stem cells, 201, 225 Peripheral Vascular Disease, 6, 225 Peritoneal, 208, 225 Peritoneal Cavity, 208, 225 Peroneal Nerve, 225, 236 Peroxide, 121, 175, 225 Personality Disorders, 24, 225 Pertussis, 79, 225, 250 Petrolatum, 112, 193, 225 Petroleum, 225 Phallic, 197, 225 Phantom, 19, 225 Pharmaceutical Preparations, 180, 196, 199, 226, 230
265
Pharmaceutical Solutions, 191, 226 Pharmacodynamics, 92, 226 Pharmacokinetic, 226 Pharmacologic, 113, 132, 134, 169, 201, 226, 245 Pharmacotherapy, 47, 53, 92, 132, 226 Pharyngeal Muscles, 23, 226 Pharynx, 205, 217, 221, 226, 243, 248 Phenolphthalein, 193, 226 Phenotype, 23, 34, 226 Phenoxybenzamine, 108, 226 Phenyl, 102, 115, 191, 213, 226 Phenylalanine, 226, 247 Phenytoin, 34, 178, 226 Phobias, 24, 226 Phonophoresis, 208, 226 Phospholipids, 197, 226 Phosphorus, 178, 227 Physical Examination, 134, 200, 227 Physiologic, 117, 136, 166, 201, 227, 233, 237, 246 Physiology, 8, 9, 14, 23, 36, 50, 62, 63, 66, 67, 81, 174, 193, 201, 219, 227 Physostigmine, 217, 227 Pigment, 175, 227 Pilot study, 68, 76, 227 Pitch, 16, 227 Plant Oils, 220, 227 Plants, 167, 173, 179, 182, 183, 193, 200, 215, 220, 227, 235, 245, 246 Plaque, 118, 227 Plasma protein, 93, 167, 194, 227 Plasticity, 6, 8, 16, 18, 32, 37, 227 Plastids, 221, 227 Platelet Aggregation, 169, 219, 227 Platelets, 219, 227 Pleomorphic, 220, 228 Plexus, 177, 181, 228, 236 Pneumonia, 186, 228 Podiatry, 117, 228 Point Mutation, 22, 228 Poisoning, 188, 195, 208, 213, 217, 228 Polyethylene, 101, 109, 113, 118, 228, 242 Polyethylene Glycols, 228, 242 Polymers, 100, 228, 231, 241 Polyneuritis, 190, 228 Polypeptide, 168, 184, 195, 197, 228, 231, 251 Polysaccharide, 166, 171, 180, 228 Pons, 177, 228, 234, 235 Posterior, 7, 10, 122, 169, 181, 191, 209, 222, 228, 239
Postherpetic Neuralgia, 76, 106, 139, 228 Postoperative, 13, 49, 56, 61, 64, 73, 82, 114, 134, 213, 228 Postsynaptic, 218, 228 Post-synaptic, 28 Post-synaptic, 228 Post-traumatic, 24, 51, 108, 202, 228 Potassium, 5, 80, 165, 228, 229, 232, 238 Potassium Channels, 5, 165, 229 Potentiate, 223, 229 Potentiating, 168, 229 Potentiation, 18, 73, 91, 182, 211, 229 Practice Guidelines, 150, 229 Preclinical, 26, 33, 229 Precursor, 182, 191, 192, 194, 220, 226, 229, 247 Prefrontal Cortex, 7, 11, 17, 31, 229 Pregnancy Tests, 200, 229 Premenstrual Syndrome, 127, 229 Prenatal, 88, 193, 229 Prepuce, 183, 229 Pressoreceptors, 174, 229 Presynaptic, 9, 218, 219, 229, 243 Presynaptic Terminals, 218, 229, 243 Prevalence, 12, 128, 134, 194, 229 Probe, 126, 201, 214, 229 Procaine, 108, 110, 124, 130, 229 Proctitis, 127, 230 Progesterone, 230, 240 Progression, 120, 170, 230 Progressive, 183, 189, 192, 216, 217, 221, 230, 247 Projection, 24, 207, 220, 221, 229, 230, 234, 249 Proline, 184, 204, 230 Propafenone, 116, 230 Prophase, 230, 243 Prophylaxis, 118, 230, 248 Propofol, 6, 43, 47, 53, 56, 60, 67, 73, 78, 90, 93, 230 Propranolol, 40, 89, 230 Proprioception, 70, 230 Propylene Glycol, 123, 230 Prospective study, 78, 230 Prostate, 34, 70, 75, 78, 138, 230, 246 Protein Binding, 230, 245 Protein C, 22, 167, 168, 174, 230, 247 Protein Conformation, 168, 230 Protein S, 176, 195, 231, 244 Proteolytic, 168, 184, 197, 231 Protocol, 7, 19, 34, 136, 231 Protons, 167, 204, 231, 232
266
Lidocaine
Protozoa, 185, 214, 231, 248 Pseudorabies, 23, 231 Psychiatric, 31, 184, 231 Psychiatry, 197, 231, 241, 249 Psychic, 213, 231, 236 Psychoactive, 17, 231, 251 Psychomotor, 178, 188, 218, 231 Psychosis, 171, 200, 231 Psychotomimetic, 169, 189, 231 Psychotropic, 133, 231 Psychotropic Drugs, 133, 231 Public Health, 30, 37, 150, 231 Public Policy, 149, 232 Publishing, 39, 232 Pulmonary, 4, 167, 176, 177, 232, 234, 242, 249 Pulmonary Artery, 176, 232, 249 Pulmonary Ventilation, 232, 234 Pulse, 126, 215, 232 Pupil, 74, 186, 190, 216, 232 Pyogenic, 221, 232 Q Quality of Life, 52, 79, 232 Quaternary, 13, 230, 232, 241 Quinidine, 12, 81, 89, 182, 232 Quinine, 21, 182, 232 R Race, 11, 26, 167, 189, 215, 232 Racemic, 26, 167, 189, 232 Radial Artery, 42, 232 Radial Keratotomy, 110, 232 Radiation, 118, 120, 169, 174, 196, 198, 204, 206, 207, 209, 224, 225, 232, 233, 251 Radiation therapy, 196, 204, 207, 209, 224, 233, 251 Radicular, 44, 59, 233 Radioactive, 100, 174, 201, 204, 206, 207, 208, 209, 220, 233, 247, 251 Radiography, 200, 205, 233 Radiolabeled, 209, 233, 251 Radiotherapy, 177, 209, 233, 240, 251 Randomized clinical trial, 67, 233 Reactive Oxygen Species, 15, 233 Receptors, Adrenergic, 189, 233 Receptors, Serotonin, 233, 237 Rectal, 7, 123, 124, 127, 233, 242 Rectum, 127, 170, 172, 177, 184, 188, 198, 199, 202, 206, 210, 230, 233, 242, 246 Recur, 101, 224, 233 Recurrence, 224, 233 Red Nucleus, 234, 249 Reentry, 30, 234
Refer, 1, 37, 178, 184, 191, 194, 197, 198, 203, 207, 211, 212, 218, 219, 231, 234, 245, 249 Reflex, 5, 15, 30, 44, 66, 70, 108, 134, 197, 216, 234 Reflux, 234, 241 Refraction, 217, 234, 239 Refractory, 68, 234 Regimen, 192, 224, 226, 234 Relapse, 11, 17, 234 Relaxant, 222, 226, 234, 241 Renal pelvis, 209, 234 Resected, 71, 234 Respiration, 14, 172, 179, 181, 187, 215, 234 Respiratory Physiology, 234, 249 Respiratory System, 109, 167, 234 Resuscitation, 33, 88, 179, 234 Reticular, 6, 23, 234 Reticular Formation, 6, 23, 234 Retina, 182, 210, 217, 221, 234, 235 Retinal, 30, 174, 185, 221, 234, 235 Retinol, 234, 235 Retrobulbar, 52, 59, 92, 235 Retrospective, 38, 235 Retrospective Studies, 38, 235 Rheumatism, 235 Rheumatoid, 54, 115, 124, 184, 217, 235 Rheumatoid arthritis, 54, 115, 124, 184, 217, 235 Rhodopsin, 174, 221, 234, 235 Ribose, 165, 235 Rickettsiae, 235, 248 Risk factor, 230, 235 Rod, 183, 235 Round Window, 132, 235 Rubber, 118, 165, 235 S Saccades, 16, 235 Salicylic, 129, 130, 235 Saline, 11, 34, 48, 54, 119, 123, 235 Sanitary, 121, 235 Saphenous, 20, 235 Saponins, 235, 240 Satellite, 35, 236 Scatter, 225, 236 Schizoid, 24, 236, 251 Schizophrenia, 171, 236, 249, 251 Schizotypal Personality Disorder, 236, 251 Sciatic Nerve, 20, 225, 236, 244 Sclerosis, 122, 184, 216, 236 Screening, 8, 27, 183, 236 Sebaceous, 189, 236
267
Sebaceous gland, 189, 236 Secondary tumor, 214, 236 Secretion, 190, 195, 203, 207, 214, 236, 237, 248 Secretory, 218, 236 Sedative, 168, 183, 189, 214, 236 Segmental, 65, 236 Segmentation, 236 Seizures, 13, 36, 76, 178, 188, 223, 226, 236 Semen, 193, 230, 237 Semicircular canal, 207, 237 Sensibility, 169, 204, 237 Sensitization, 18, 26, 237 Sensor, 29, 237 Sensory loss, 133, 216, 237 Sequela, 19, 237 Sequence Homology, 224, 237 Serotonin, 9, 31, 132, 168, 171, 189, 219, 226, 233, 237, 247 Serotonin Agonists, 237 Serotonin Antagonists, 132, 237 Serous, 194, 237 Serum, 27, 76, 127, 167, 169, 172, 184, 212, 237, 247 Sex Characteristics, 237, 243 Shock, 34, 39, 169, 204, 237, 246 Side effect, 13, 19, 26, 36, 102, 111, 117, 121, 132, 141, 166, 167, 171, 181, 209, 237, 245 Signs and Symptoms, 19, 234, 238, 247 Sinoatrial Node, 197, 238 Skeletal, 5, 8, 22, 63, 107, 182, 183, 187, 209, 216, 218, 232, 238, 239, 241 Skeleton, 238 Skin Care, 101, 238 Skin graft, 26, 238 Skull, 187, 238, 243 Sleep apnea, 36, 238 Small intestine, 192, 203, 208, 217, 238 Smooth muscle, 5, 167, 169, 177, 203, 215, 219, 222, 238, 239, 241 Sneezing, 225, 238 Soaps, 238 Social Behavior, 23, 238, 250 Social Environment, 232, 238 Sodium Bicarbonate, 45, 238 Sodium Channels, 8, 22, 34, 63, 67, 130, 232, 238, 248 Soft tissue, 115, 117, 129, 177, 238, 239 Solid tumor, 176, 239 Solitary Nucleus, 174, 239 Solvent, 175, 196, 200, 221, 226, 230, 239
Soma, 20, 239 Somatic, 203, 211, 213, 215, 225, 229, 239, 248 Somatic cells, 213, 215, 239 Somatosensory Cortex, 21, 37, 239 Sonogram, 239, 246 Sound wave, 185, 239, 246 Spasm, 112, 203, 239 Spasmodic, 225, 239 Spastic, 113, 209, 239 Specialist, 155, 190, 239 Species, 24, 178, 187, 195, 204, 213, 215, 223, 232, 233, 237, 238, 239, 241, 246, 247, 250, 251 Specificity, 166, 178, 239, 245 Spectrum, 120, 180, 209, 214, 239 Sphincter, 45, 112, 210, 239 Spike, 30, 239 Spinal Cord Vascular Diseases, 216, 240 Spinal Nerves, 225, 240 Spiral Ganglion, 183, 240, 249 Spiral Lamina, 240, 247 Stabilization, 226, 240 Stasis, 240, 249 Steady state, 5, 240 Steatosis, 58, 240 Steel, 183, 240 Stereotactic, 20, 240 Sterile, 107, 169, 240 Sterilization, 100, 138, 240 Steroid, 54, 109, 236, 240 Stimulant, 168, 189, 203, 209, 240 Stimulus, 9, 17, 28, 186, 192, 193, 196, 207, 208, 210, 226, 234, 240, 244 Stomach, 165, 173, 195, 199, 203, 217, 225, 226, 234, 238, 240 Stomatitis, 129, 240 Stool, 184, 206, 209, 210, 240 Strabismus, 48, 240 Strand, 91, 241 Stress, 10, 15, 24, 31, 101, 174, 180, 209, 217, 235, 241, 248 Striatum, 11, 220, 241 Stroke, 24, 112, 148, 179, 241 Stupor, 217, 241 Styptic, 113, 241 Styrene, 100, 235, 241 Subacute, 207, 241 Subarachnoid, 49, 92, 201, 241 Subclinical, 207, 236, 241 Subcutaneous, 20, 37, 103, 104, 120, 192, 211, 223, 241
268
Lidocaine
Subiculum, 24, 203, 241 Submaxillary, 195, 241 Submucous, 124, 241 Subspecies, 239, 241 Substance P, 126, 195, 214, 236, 241 Substrate, 11, 24, 194, 241 Succinylcholine, 54, 241 Sucralfate, 112, 241 Suction, 81, 211, 242 Sudden cardiac death, 12, 30, 242 Sufentanil, 60, 242 Supplementation, 90, 242 Suppositories, 85, 122, 199, 242 Suppository, 127, 228, 242 Suppression, 28, 70, 102, 110, 134, 242 Supratentorial, 52, 242 Supraventricular, 4, 242 Surfactant, 116, 242 Suspensions, 119, 242, 248 Sweat, 189, 242 Sweat Glands, 189, 242 Sympathetic Nervous System, 5, 15, 133, 174, 219, 223, 242 Sympathomimetic, 168, 189, 191, 195, 209, 220, 242 Symphysis, 182, 230, 242 Symptomatic, 170, 198, 222, 242 Synapse, 166, 189, 218, 223, 229, 242, 246 Synaptic, 8, 18, 20, 30, 211, 219, 242, 243 Synaptic Vesicles, 243 Syncope, 68, 243 Systemic, 9, 33, 35, 39, 62, 64, 66, 72, 77, 101, 105, 111, 115, 116, 120, 132, 138, 169, 172, 176, 184, 188, 190, 195, 202, 207, 208, 209, 233, 238, 240, 241, 243, 248, 251 Systemic disease, 101, 243 Systolic, 205, 243 T Tachycardia, 4, 62, 82, 139, 243 Tardive, 171, 243 Taste Buds, 200, 243 Taurine, 90, 243 Tea Tree Oil, 95, 120, 243 Telencephalon, 175, 181, 243 Temporal, 9, 30, 169, 173, 202, 203, 212, 243 Temporal Lobe, 169, 173, 243 Tendon, 178, 199, 243 Testosterone, 12, 243 Tetani, 243 Tetanic, 243
Tetanus, 79, 243 Tetracaine, 105, 110, 117, 243 Tetracycline, 100, 244 Tetrodotoxin, 22, 34, 244 Thalamic, 6, 7, 16, 37, 244 Thalamus, 6, 7, 10, 16, 20, 186, 190, 211, 229, 244 Theophylline, 5, 244 Therapeutics, 11, 31, 48, 143, 244 Thermal, 27, 32, 118, 191, 219, 244 Thoracic, 46, 81, 177, 190, 212, 244, 250 Thorax, 165, 212, 244, 248 Threonine, 224, 244 Threshold, 6, 8, 77, 196, 205, 244 Thrombin, 197, 227, 230, 244 Thrombomodulin, 230, 244 Thrombosed, 112, 244 Thrombosis, 231, 241, 244 Thymidine, 34, 244 Thyroid, 205, 244, 247 Tibial Nerve, 236, 244 Tinnitus, 15, 43, 63, 64, 78, 88, 89, 91, 92, 94, 132, 134, 138, 244, 250 Tissue, 8, 29, 31, 38, 89, 93, 101, 102, 107, 116, 121, 122, 124, 127, 171, 173, 175, 176, 177, 178, 179, 181, 182, 184, 185, 186, 187, 188, 192, 193, 194, 197, 198, 199, 201, 205, 207, 208, 210, 212, 213, 214, 215, 216, 217, 218, 219, 221, 222, 224, 225, 227, 234, 237, 239, 240, 242, 245, 246, 247 Tissue Distribution, 89, 245 Tolerance, 33, 39, 165, 245 Tomography, 15, 78, 245 Tone, 15, 16, 36, 221, 245 Tonic, 5, 33, 245 Tonus, 245 Tooth Preparation, 165, 245 Tourniquet, 41, 245 Toxic, iv, 14, 36, 110, 117, 173, 175, 182, 185, 187, 188, 190, 219, 241, 245 Toxicity, 26, 37, 56, 67, 84, 105, 138, 192, 193, 213, 227, 241, 245 Toxicokinetics, 245 Toxicology, 49, 55, 150, 245 Toxin, 8, 23, 45, 53, 113, 190, 243, 244, 245 Trabecular Meshwork, 245, 246 Trabeculectomy, 60, 246 Trachea, 87, 177, 178, 196, 210, 226, 244, 246 Traction, 183, 246 Tranquilizing Agents, 231, 246
269
Transcutaneous, 76, 87, 246 Transdermal, 44, 74, 104, 105, 107, 112, 117, 126, 127, 246 Transduction, 5, 246 Transfection, 176, 246 Translation, 168, 195, 246 Translocation, 195, 246 Transmitter, 165, 173, 191, 208, 213, 220, 243, 246 Transplantation, 13, 43, 57, 58, 72, 205, 212, 246 Transrectal ultrasound, 70, 246 Transurethral, 138, 246 Trauma, 34, 50, 51, 101, 110, 188, 195, 217, 222, 246 Trees, 182, 235, 246 Tremor, 20, 223, 246 Triad, 56, 246 Triamcinolone Acetonide, 101, 102, 246 Tricyclic, 25, 38, 111, 132, 168, 170, 189, 246 Trigeminal, 21, 104, 211, 212, 247 Trigger zone, 171, 247 Trimecaine, 92, 247 Tryptophan, 184, 237, 247 Tubercle, 220, 247 Tuberculosis, 235, 247 Tubocurarine, 217, 247 Tumor Necrosis Factor, 38, 247 Tumorigenic, 35, 247 Tumour, 199, 247 Tunica, 216, 247 Tympani, 21, 243, 247 Tyrosine, 64, 191, 247 U Ulcer, 129, 133, 188, 241, 247 Ultrasonography, 200, 247 Unconscious, 169, 247 Uraemia, 222, 247 Urea, 13, 121, 242, 247 Ureters, 125, 209, 247, 248 Urethane, 124, 247 Urethra, 125, 224, 230, 246, 248 Urinary, 79, 125, 133, 180, 182, 187, 190, 204, 206, 247, 248 Urinary tract, 125, 180, 190, 248 Urinate, 248, 250 Urine, 58, 125, 133, 176, 191, 195, 201, 206, 209, 234, 247, 248 Urticaria, 3, 4, 169, 248 Uterus, 181, 186, 194, 205, 222, 230, 248
V Vaccination, 105, 248 Vaccines, 79, 120, 248, 250 Vacuoles, 221, 248 Vagal, 4, 248 Vagina, 181, 205, 248 Vaginal, 81, 212, 242, 248 Vagus Nerve, 239, 248 Valproic Acid, 77, 248 Valves, 248, 249 Varicella, 112, 248 Vascular Resistance, 168, 175, 248 Vasculitis, 124, 222, 248 Vasoconstriction, 5, 134, 195, 248 Vasodilation, 5, 84, 222, 248 Vasodilator, 177, 191, 203, 209, 222, 226, 249 Vasomotor, 108, 249 Vector, 246, 249 Vein, 109, 169, 208, 220, 235, 236, 244, 249 Venous, 43, 80, 91, 128, 219, 231, 249 Venous Insufficiency, 128, 249 Venter, 249 Ventilation, 5, 94, 179, 249 Ventral, 18, 183, 205, 220, 228, 240, 249 Ventral Tegmental Area, 18, 249 Ventricle, 169, 173, 180, 203, 205, 220, 232, 238, 243, 244, 249 Ventricular, 30, 34, 39, 62, 80, 90, 106, 139, 168, 198, 204, 230, 249 Ventricular fibrillation, 30, 34, 249 Venules, 176, 178, 194, 214, 249 Vertebrae, 240, 249 Vertigo, 30, 249, 250 Vesicular, 203, 249 Vestibular, 9, 30, 201, 249, 250 Vestibule, 183, 207, 237, 249 Vestibulocochlear Nerve, 173, 183, 245, 249, 250 Vestibulocochlear Nerve Diseases, 245, 250 Veterinary Medicine, 149, 250 Viral, 118, 119, 120, 124, 246, 247, 250 Virulence, 173, 245, 250 Virus, 23, 58, 112, 119, 120, 174, 180, 194, 201, 227, 246, 250, 251 Visceral, 7, 28, 174, 211, 248, 250 Visceral Afferents, 174, 248, 250 Viscosity, 176, 204, 250 Vitro, 30, 38, 202, 250 Vivo, 35, 212, 250 Vocal cord, 134, 200, 250
270
Lidocaine
Void, 34, 250 Voltage-gated, 8, 12, 13, 22, 34, 250 Vomeronasal Organ, 220, 250 W War, 108, 250 Warts, 119, 120, 250 White blood cell, 170, 210, 212, 215, 219, 250 Whooping Cough, 225, 250 Windpipe, 178, 194, 226, 244, 250 Withdrawal, 11, 84, 188, 213, 251
X Xenograft, 170, 251 X-ray, 133, 186, 198, 209, 220, 233, 240, 251 X-ray therapy, 209, 251 Y Yeasts, 198, 199, 226, 251 Z Zoster, 111, 112, 251 Zygote, 185, 251 Zymogen, 230, 251
271
272
Lidocaine
